@article{MTMT:30869114,
	title = {A management algorithm for patients with intracranial pressure monitoring : the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)},
	url = {https://m2.mtmt.hu/api/publication/30869114},
	author = {Hawryluk, Gregory W J and Aguilera, Sergio and Büki, András and Bulger, Eileen and Citerio, Giuseppe and Cooper, D Jamie and Arrastia, Ramon Diaz and Diringer, Michael and Figaji, Anthony and Gao, Guoyi and Geocadin, Romergryko and Ghajar, Jamshid and Harris, Odette and Hoffer, Alan and Hutchinson, Peter and Joseph, Mathew and Kitagawa, Ryan and Manley, Geoffrey and Mayer, Stephan and Menon, David K and Meyfroidt, Geert and Michael, Daniel B and Oddo, Mauro and Okonkwo, David and Patel, Mayur and Robertson, Claudia and Rosenfeld, Jeffrey V and Rubiano, Andres M and Sahuquillo, Juan and Servadei, Franco and Shutter, Lori and Stein, Deborah and Stocchetti, Nino and Taccone, Fabio Silvio and Timmons, Shelly and Tsai, Eve and Ullman, Jamie S and Vespa, Paul and Videtta, Walter and Wright, David W and Zammit, Christopher and Chesnut, Randall M},
	doi = {10.1007/s00134-019-05805-9},
	journal-iso = {INTENS CARE MED},
	journal = {INTENSIVE CARE MEDICINE},
	volume = {45},
	unique-id = {30869114},
	issn = {0342-4642},
	abstract = {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.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.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.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.},
	keywords = {ALGORITHM; PROTOCOL; Consensus; Intracranial Pressure; brain injury; SEATTLE; Head trauma; SIBICC; Tiers},
	year = {2019},
	eissn = {1432-1238},
	pages = {1783-1794}
}