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Variation in Blood ...
Variation in Blood Transfusion and Coagulation Management in Traumatic Brain Injury at the Intensive Care Unit : A Survey in 66 Neurotrauma Centers Participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Study
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Huijben, Jilske A. (author)
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van der Jagt, Mathieu (author)
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Cnossen, Maryse C. (author)
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Kruip, Marieke J. H. A. (author)
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Haitsma, Iain K. (author)
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Stocchetti, Nino (author)
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Maas, Andrew I. R. (author)
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Menon, David K. (author)
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Ercole, Ari (author)
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Maegele, Marc (author)
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Stanworth, Simon J. (author)
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Citerio, Giuseppe (author)
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Polinder, Suzanne (author)
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Steyerberg, Ewout W. (author)
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Lingsma, Hester F. (author)
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- Koskinen, Lars-Owe D., Professor, 1955- (contributor)
- Center-TBI Investigators and Participants
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- Brorsson, Camilla (author)
- Umeå universitet,Anestesiologi och intensivvård
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(creator_code:org_t)
- Mary Ann Liebert, 2017
- 2017
- English.
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In: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 35:2, s. 323-332
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https://repository.u...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Our aim was to describe current approaches and to quantify variability between European intensive care units (ICUs) in patients with traumatic brain injury (TBI). Therefore, we conducted a provider profiling survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The ICU Questionnaire was sent to 68 centers from 20 countries across Europe and Israel. For this study, we used ICU questions focused on 1) hemoglobin target level (Hb-TL), 2) coagulation management, and 3) deep venous thromboembolism (DVT) prophylaxis. Seventy-eight participants, mostly intensivists and neurosurgeons of 66 centers, completed the ICU questionnaire. For ICU-patients, half of the centers (N = 34; 52%) had a defined Hb-TL in their protocol. For patients with TBI, 26 centers (41%) indicated an Hb-TL between 70 and 90 g/L and 38 centers (59%) above 90 g/L. To treat trauma-related hemostatic abnormalities, the use of fresh frozen plasma (N = 48; 73%) or platelets (N = 34; 52%) was most often reported, followed by the supplementation of vitamin K (N = 26; 39%). Most centers reported using DVT prophylaxis with anticoagulants frequently or always (N = 62; 94%). In the absence of hemorrhagic brain lesions, 14 centers (21%) delayed DVT prophylaxis until 72 h after trauma. If hemorrhagic brain lesions were present, the number of centers delaying DVT prophylaxis for 72 h increased to 29 (46%). Overall, a lack of consensus exists between European ICUs on blood transfusion and coagulation management. The results provide a baseline for the CENTER-TBI study, and the large between-center variation indicates multiple opportunities for comparative effectiveness research.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- Europe
- coagulopathy
- intensive care unit
- transfusion
- traumatic brain injury
- neurokirurgi
- Neurosurgery
- anestesiologi
- Anaesthesiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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Huijben, Jilske ...
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van der Jagt, Ma ...
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Cnossen, Maryse ...
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Kruip, Marieke J ...
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Haitsma, Iain K.
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Stocchetti, Nino
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show more...
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Maas, Andrew I. ...
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Menon, David K.
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Ercole, Ari
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Maegele, Marc
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Stanworth, Simon ...
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Citerio, Giusepp ...
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Polinder, Suzann ...
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Steyerberg, Ewou ...
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Lingsma, Hester ...
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Koskinen, Lars-O ...
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Brorsson, Camill ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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Journal of Neuro ...
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Umeå University