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  • Hawryluk, Gregory W. J.Section of Neurosurgery, University of Manitoba, Winnipeg, Canada (author)

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

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2019-10-28
  • Springer,2019
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-113624
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-113624URI
  • https://doi.org/10.1007/s00134-019-05805-9DOI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

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

Notes

  • Funding Agencies:National Institutes of Health Research (NIHR)  American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Neurotrauma and Critical Care, Bard Brain Trauma Foundation DePuy Hemedex Integra Neurointensive Care Section of the European Society of Intensive Care Medicine Neurosurgical Society of Australasia Medtronic Moberg Research National University of Singapore  NeuropticsRaumedicSophysaStrykerZollNIHR (Cambridge BRC) NIHR (Global Health Research Group on Neurotrauma) 
  • Background: Management algorithms for adult severe traumatic brain injury (sTBI) were omitted in later editions of the Brain Trauma Foundation's sTBI Management Guidelines, as they were not evidence-based.Methods: We used a Delphi-method-based consensus approach to address management of sTBI patients undergoing intracranial pressure (ICP) monitoring. Forty-two experienced, clinically active sTBI specialists from six continents comprised the panel. Eight surveys iterated queries and comments. An in-person meeting included whole- and small-group discussions and blinded voting. Consensus required 80% agreement. We developed heatmaps based on a traffic-light model where panelists' decision tendencies were the focus of recommendations.Results: We provide comprehensive algorithms for ICP-monitor-based adult sTBI management. Consensus established 18 interventions as fundamental and ten treatments not to be used. We provide a three-tier algorithm for treating elevated ICP. Treatments within a tier are considered empirically equivalent. Higher tiers involve higher risk therapies. Tiers 1, 2, and 3 include 10, 4, and 3 interventions, respectively. We include inter-tier considerations, and recommendations for critical neuroworsening to assist the recognition and treatment of declining patients. Novel elements include guidance for autoregulation-based ICP treatment based on MAP Challenge results, and two heatmaps to guide (1) ICP-monitor removal and (2) consideration of sedation holidays for neurological examination.Conclusions: Our modern and comprehensive sTBI-management protocol is designed to assist clinicians managing sTBI patients monitored with ICP-monitors alone. Consensus-based (class III evidence), it provides management recommendations based on combined expert opinion. It reflects neither a standard-of-care nor a substitute for thoughtful individualized management.

Subject headings and genre

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  • Aguilera, SergioAlmirante Nef Naval Hospital, Valparaiso University, Viña Del Mar, Chile; Valparaiso University, Valparaiso, Chile (author)
  • Büki, Andras,1966-Department of Neurosurgery, Medical School and Szentágothai Research Centre, Pécs, Hungary; University of Pécs, Pécs, Hungary(Swepub:oru)asbi (author)
  • Bulger, EileenDepartment of Surgery, Harborview Medical Center, University of Washington, Seattle, USA (author)
  • Citerio, GiuseppeSchool of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; Anaesthesia and Intensive Care, San Gerardo and Desio Hospitals, ASST-Monza, Monza, Italy (author)
  • Cooper, D. JamieIntensive 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, Australia (author)
  • Arrastia, Ramon DiazDepartment of Neurology, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA (author)
  • Diringer, MichaelDepartment of Neurology, Washington University School of Medicine, St. Louis, USA; Department of Neurology, Barnes-Jewish Hospital, 1 Barnes Jewish Hospital Plaza, St. Louis, USA (author)
  • Figaji, AnthonyDivision of Neurosurgery and Neuroscience Institute, Groote Schuur Hospital¸University of Cape Town, H53 Old Main Building, South Africa (author)
  • Gao, GuoyiDepartment of Neurosurgery, Renji Hospital, Shanghai Institute of Head Trauma, Shanghai Jiaotong University School of Medicine, Shanghai, China (author)
  • Geocadin, RomergrykoDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, USA (author)
  • Ghajar, JamshidDepartment of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, USA (author)
  • Harris, OdetteDepartment of Neurosurgery, Stanford, USA (author)
  • Hoffer, AlanDepartment of Neurological Surgery, School of Medicine, Case Western Reserve University, Cleveland, USA (author)
  • Hutchinson, PeterDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge and Cambridge Biomedical Campus, Cambridge, UK (author)
  • Joseph, MathewDepartment of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India (author)
  • Kitagawa, RyanVivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, Houston, USA (author)
  • Manley, GeoffreyDepartment of Neurosurgery, San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA (author)
  • Mayer, StephanDepartment of Neurology, Henry Ford Hospital, Detroit, USA (author)
  • Menon, David K.Division of Anaesthesia, Addenbrooke's Hospital, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK (author)
  • Meyfroidt, GeertDepartment and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Leuven, Belgium (author)
  • Michael, Daniel B.Department of Neurosurgery, Beaumont Health, Michigan Head and Spine Institute, Oakland University William Beaumont School of Medicine, Southfield, USA (author)
  • Oddo, MauroDepartment of Intensive Care Medicine, Faculty of Biology and Medicine, CHUV-Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland (author)
  • Okonkwo, DavidDepartment of Neurosurgery, University of Pittsburgh Medical Center Presbyterian, Pittsburgh, USA (author)
  • Patel, MayurDepartment of Surgery, Vanderbilt University Medical Center, Nashville, USA (author)
  • Robertson, ClaudiaDepartment of Neurosurgery, Baylor College of Medicine, Houston, USA (author)
  • Rosenfeld, Jeffrey V.Department of Neurosurgery, Alfred Hospital, Melbourne, Australia; Department of Surgery, Monash University, Melbourne, Australia (author)
  • Rubiano, Andres M.INUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia; MEDITECH Foundation, Clinical Research, Bogotá, Colombia (author)
  • Sahuquillo, JuanDepartment of Neurosurgery, University Hospital Vall d'Hebron, Barcelona, Spain (author)
  • Servadei, FrancoDepartment of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy (author)
  • Shutter, LoriDepartment of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, USA (author)
  • Stein, DeborahDepartment of Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, USA (author)
  • Stocchetti, NinoDepartment of Physiopathology and Transplantation, Milan University, Milan, Italy; Neuroscience Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy (author)
  • Taccone, Fabio SilvioDepartment of Intensive Care, Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium (author)
  • Timmons, ShellyDepartment of Neurological Surgery, Indianapolis, USA (author)
  • Tsai, EveSuruchi Bhargava Chair in Spinal Cord and Brain Regeneration Research, The Ottawa Hospital, Department of Surgery, Division of Neurosurgery, University of Ottawa, Civic Campus, Ottawa, Canada (author)
  • Ullman, Jamie S.Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, New York, USA (author)
  • Vespa, PaulGary L. Brinderson Family Chair in Neurocritical Care, UCLA School of Medicine, Los Angeles, USA; Critical Care Medicine Research, UCLA School of Medicine, Santa Monica, USA; Neurosurgery and Neurology, UCLA School of Medicine, Santa Monica, USA; Neurocritical Care, Ronald Reagan UCLA Medical Center, Santa Monica, USA (author)
  • Videtta, WalterIntensive Care, Posadas Hospital, Buenos Aires, Argentina (author)
  • Wright, David W.Department of Emergency Medicine, Emory University School of Medicine, Atlanta, USA (author)
  • Zammit, ChristopherDepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA (author)
  • Chesnut, Randall M.Department of Neurological Surgery, University of Washington, Seattle, USA; Department of Orthopaedic Surgery, University of Washington, Seattle, USA; School of Global Health, University of Washington, Seattle, USA; Harborview Medical Center, University of Washington, USA (author)
  • Section of Neurosurgery, University of Manitoba, Winnipeg, CanadaAlmirante Nef Naval Hospital, Valparaiso University, Viña Del Mar, Chile; Valparaiso University, Valparaiso, Chile (creator_code:org_t)

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  • In:Intensive Care Medicine: Springer45:12, s. 1783-17940342-46421432-1238

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