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Variation in Blood ...
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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
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LIBRIS-ID:oai:DiVA.org:umu-167885
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-167885URI
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https://doi.org/10.1089/neu.2017.5194DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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.
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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.
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Koskinen, Lars-Owe D.,Professor,1955-Center-TBI Investigators and Participants(Swepub:umu)lako0002
(contributor)
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Brorsson, CamillaUmeå universitet,Anestesiologi och intensivvård(Swepub:umu)brca0001(author)
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Center-TBI Investigators and ParticipantsAnestesiologi och intensivvård
(creator_code:org_t)
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In:Journal of Neurotrauma: Mary Ann Liebert35:2, s. 323-3320897-71511557-9042
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Menon, David K.
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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