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  • Huijben, Jilske A. (author)

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

  • Article/chapterEnglish2017

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  • Mary Ann Liebert,2017
  • printrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:umu-167885
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-167885URI
  • https://doi.org/10.1089/neu.2017.5194DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • van der Jagt, Mathieu (author)
  • Cnossen, Maryse C. (author)
  • Kruip, Marieke J. H. A. (author)
  • Haitsma, Iain K. (author)
  • Stocchetti, Nino (author)
  • Maas, Andrew I. R. (author)
  • Menon, David K. (author)
  • Ercole, Ari (author)
  • Maegele, Marc (author)
  • Stanworth, Simon J. (author)
  • Citerio, Giuseppe (author)
  • Polinder, Suzanne (author)
  • Steyerberg, Ewout W. (author)
  • Lingsma, Hester F. (author)
  • Koskinen, Lars-Owe D.,Professor,1955-Center-TBI Investigators and Participants(Swepub:umu)lako0002 (contributor)
  • Brorsson, CamillaUmeå universitet,Anestesiologi och intensivvård(Swepub:umu)brca0001(author)
  • Center-TBI Investigators and ParticipantsAnestesiologi och intensivvård (creator_code:org_t)

Related titles

  • In:Journal of Neurotrauma: Mary Ann Liebert35:2, s. 323-3320897-71511557-9042

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