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Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury : A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations

Chesnut, Randall M. (författare)
Department of Neurological Surgery, University of Washington, Seattle, Washington, USA; Department of Orthopaedic Surgery, University of Washington, Seattle, Washington, USA; School of Global Health, University of Washington, Seattle, Washington, USA; Harborview Medical Center, University of Washington, Seattle, Washington, USA
Aguilera, Sergio (författare)
Almirante Nef Naval Hospital, Valparaiso University, Viña Del Mar, Chile; Valparaiso University, Valparaiso, Chile
Buki, Andras, 1966- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Department of Neurosurgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Bulger, Eileen M. (författare)
Department of Surgery, Harborview Medical Center, University of Washington, Seattle, Washington, USA
Citerio, Giuseppe (författare)
School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; Neuroscience Department, NeuroIntensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Monza, Italy
Cooper, D. Jamie (författare)
Intensive Care Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia
Arrastia, Ramon Diaz (författare)
Department of Neurology, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
Diringer, Michael (författare)
Department of Neurology, Washington University School of Medicine, St Louis, USA; Department of Neurology, Barnes-Jewish Hospital, St Louis, Missouri, USA
Figaji, Anthony (författare)
Division of Neurosurgery and Neuroscience Institute, Groote Schuur Hospital, University of Cape Town, Observatory 7925, South Africa
Gao, Guoyi (författare)
Department of Neurosurgery, Renji Hospital, Shanghai Institute of Head Trauma, Shanghai Jiaotong University School of Medicine, Shanghai, China
Geocadin, Romergryko G. (författare)
Departments of Neurology, Neurological Surgery, Anesthesiology-Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Ghajar, Jamshid (författare)
Department of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, California, USA
Harris, Odette (författare)
Department of Neurosurgery, Stanford University School of Medicine, Center for Academic Medicine, Stanford, California, USA
Hawryluk, Gregory W. J. (författare)
Cleveland Clinic Akron General Neurosciences Center, Fairlawn, Ohio, USA; Uniformed Services University, Bethesda, Maryland, USA; Brain Trauma Foundation, New York City, New York, USA
Hoffer, Alan (författare)
UH Cleveland Medical Center, Cleveland, Ohio, USA
Hutchinson, Peter (författare)
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge and Cambridge Biomedical Campus, Cambridge, UK
Joseph, Mathew (författare)
Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
Kitagawa, Ryan (författare)
Vivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, Houston, Texas, USA
Manley, Geoffrey (författare)
Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA; Department of Neurosurgery, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA
Mayer, Stephan (författare)
Westchester Health Network, New York Medical College, Valhalla, New York, USA
Menon, David K. (författare)
Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK
Meyfroidt, Geert (författare)
Department of Intensive Care Medicine, University Hospitals Leuven and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
Michael, Daniel B. (författare)
Department of Neurosurgery, Beaumont Health, Michigan Head and Spine Institute, Oakland University William Beaumont School of Medicine, Southfield, Michigan, USA
Oddo, Mauro (författare)
CHUV Medical Directorate and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
Okonkwo, David O. (författare)
Department of Neurosurgery, University of Pittsburgh Medical Center Presbyterian, Pittsburgh, Pennsylvania, USA
Patel, Mayur B. (författare)
Department of Surgery, Division of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
Robertson, Claudia (författare)
Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA
Rosenfeld, Jeffrey V. (författare)
Department of Neurosurgery, Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia
Rubiano, Andres M. (författare)
INUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia; MEDITECH Foundation, Clinical Research, Cali, Colombia
Sahuquillo, Juain (författare)
Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona: Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
Servadei, Franco (författare)
Department of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milano, Italy
Shutter, Lori (författare)
Department of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
Stein, Deborah M. (författare)
University of Maryland School of Medicine, Adult Critical Care Services, University of Maryland Medical Center, Baltimore, Maryland, USA
Stocchetti, Nino (författare)
Department of Physiopathology and Transplantation, Milan University, Milan, Italy; Neuroscience Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
Taccone, Fabio Silvio (författare)
Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium
Timmons, Shelly D. (författare)
Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
Tsai, Eve C. (författare)
Suruchi Bhargava Chair in Spinal Cord and Brain Regeneration Research, The Ottawa Hospital, Department of Surgery, Division of Neurosurgery, University of Ottawa, Civic Campus, Ottawa, Ontario, Canada
Ullman, Jamie S. (författare)
Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, New York, USA
Videtta, Walter (författare)
Intensive Care, Posadas Hospital, Buenos Aires, Argentina
Wright, David W. (författare)
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
Zammit, Christopher (författare)
Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA
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 (creator_code:org_t)
Oxford University Press, 2023
2023
Engelska.
Ingår i: Neurosurgery. - : Oxford University Press. - 0148-396X .- 1524-4040. ; 93:2, s. 399-408
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • BACKGROUND: Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed. OBJECTIVE: To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion.METHODS: We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression.RESULTS: Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations.CONCLUSION: Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Algorithms
Consensus development
Intracranial hypertension
Intracranial pressure monitoring
Neurocritical care
Practice guidelines
Traumatic brain injury

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