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Cited by 413

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)

Open access
Chesnut, Randall, Aguilera, Sergio, Buki, Andras, Bulger, Eileen, Citerio, Giuseppe, Cooper, D. Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K., Meyfroidt, Geert, Michael, Daniel B., Oddo, Mauro, Okonkwo, David, Patel, Mayur, Robertson, Claudia, Rosenfeld, Jeffrey V., Rubiano, Andres M., Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S., Vespa, Paul, Videtta, Walter, Wright, David W., Zammit, Christopher, Hawryluk, Gregory W. J.·2020·Intensive Care Medicine

Abstract

BACKGROUND: Current guidelines for the treatment of adult severe traumatic brain injury (sTBI) consist of high-quality evidence reports, but they are no longer accompanied by management protocols, as these require expert opinion to bridge the gap between published evidence and patient care. We aimed to establish a modern sTBI protocol for adult patients with both intracranial pressure (ICP) and brain oxygen monitors in place. METHODS: Our consensus working group consisted of 42 experienced and actively practicing sTBI opinion leaders from six continents. Having previously established a protocol for the treatment of patients with ICP monitoring alone, we addressed patients who have a brain oxygen monitor in addition to an ICP monitor. The management protocols were developed through a Delphi-method-based consensus approach and were finalized at an in-person meeting. RESULTS: We established three distinct treatment protocols, each with three tiers whereby higher tiers involve therapies with higher risk. One protocol addresses the management of ICP elevation when brain oxygenation is normal. A second addresses management of brain hypoxia with normal ICP. The third protocol addresses the situation when both intracranial hypertension and brain hypoxia are present. The panel considered issues pertaining to blood transfusion and ventilator management when designing the different algorithms. CONCLUSIONS: These protocols are intended to assist clinicians in the management of patients with both ICP and brain oxygen monitors but they do not reflect either a standard-of-care or a substitute for thoughtful individualized management. These protocols should be used in conjunction with recommendations for basic care, management of critical neuroworsening and weaning treatment recently published in conjunction with the Seattle International Brain Injury Consensus Conference.

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Authors
Chesnut, R., Aguilera, S., Buki, A., Bulger, E., Citerio, G., Cooper, D. J., Arrastia, R. D., Diringer, M., Figaji, A., Gao, G., Geocadin, R., Ghajar, J., Harris, O., Hoffer, A., Hutchinson, P., Joseph, M., Kitagawa, R., Manley, G., Mayer, S., Menon, D. K., Meyfroidt, G., Michael, D. B., Oddo, M., Okonkwo, D., Patel, M., Robertson, C., Rosenfeld, J. V., Rubiano, A. M., Sahuquillo, J., Servadei, F., Shutter, L., Stein, D., Stocchetti, N., Taccone, F. S., Timmons, S., Tsai, E., Ullman, J. S., Vespa, P., Videtta, W., Wright, D. W., Zammit, C., & Hawryluk, G. W. J.
Venue
Intensive Care Medicine
Published
2020-01-21
Volume
46
Issue
5
Pages
919-929
ISSN
  • 0342-4642 (ISSN-L)
  • 1432-1238
OpenAlex
W3002232662
Cited by
413
References
1
FWCI
19.38
Type
journal article
Language
en
Open access
hybrid

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