TY - JOUR AU - Chesnut, Randall AU - Aguilera, Sergio AU - Büki, András AU - Bulger, Eileen AU - Citerio, Giuseppe AU - Cooper, D Jamie AU - Arrastia, Ramon Diaz AU - Diringer, Michael AU - Figaji, Anthony AU - Gao, Guoyi AU - Geocadin, Romer AU - Ghajar, Jamshid AU - Harris, Odette AU - Hoffer, Alan AU - Hutchinson, Peter AU - Joseph, Mathew AU - Kitagawa, Ryan AU - Manley, Geoffrey AU - Mayer, Stephan AU - Menon, David K AU - Meyfroidt, Geert AU - Michael, Daniel B AU - Oddo, Mauro AU - Okonkwo, David AU - Patel, Mayur AU - Robertson, Claudia AU - Rosenfeld, Jeffrey V AU - Rubiano, Andres M AU - Sahuquillo, Juan AU - Servadei, Franco AU - Shutter, Lori AU - Stein, Deborah AU - Stocchetti, Nino AU - Taccone, Fabio Silvio AU - Timmons, Shelly AU - Tsai, Eve AU - Ullman, Jamie S AU - Vespa, Paul AU - Videtta, Walter AU - Wright, David W AU - Zammit, Christopher AU - Hawryluk, Gregory W J TI - A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring : the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) JF - INTENSIVE CARE MEDICINE J2 - INTENS CARE MED VL - 46 PY - 2020 SP - 919 EP - 929 PG - 11 SN - 0342-4642 DO - 10.1007/s00134-019-05900-x UR - https://m2.mtmt.hu/api/publication/31138432 ID - 31138432 N1 - Department of Neurological Surgery, Harborview Medical Center, University of Washington, 325 Ninth Ave, Mailstop 359766, Seattle, WA 98104-2499, United States Department of Orthopaedic Surgery, Harborview Medical Center, University of Washington, 325 Ninth Ave, Mailstop 359766, Seattle, WA 98104-2499, United States Almirante Nef Naval Hospital, Viña del Mar, Chile Valparaiso University, Valparaiso, Chile Department of Neurosurgery, Medical School and Szentágothai Research Centre, Ifjúság útja 20, Pécs, 7624, Hungary University of Pécs, Pécs, Hungary Department of Surgery, Harborview Medical Center, University of Washington, 325 Ninth Ave, Seattle, WA 98104-2499, United States School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy Neuro-Intensive Care, Department of Emergency and Intensive Care, ASST, San Gerardo Hospital, Monza, Italy Intensive Care Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Monash, Australia Department of Intensive Care, Alfred Hospital, Melbourne, VIC, Australia University of Pennsylvania Perelman School of Medicine, Penn Presbyterian Medical Center, 51 North 39th Street, Philadelphia, PA 19104, United States Department of Neurology, Barnes-Jewish Hospital, Washington University School of Medicine, 1 Barnes-Jewish Hospital Plaza, St. Louis, MO 63110, United States Division of Neurosurgery and Neuroscience Institute, University of Cape Town, H53 Old Main Building, Groote Schuur Hospital, Main Road, Observatory, 7925, South Africa Department of Neurosurgery, Renji Hospital, Shanghai Institute of Head Trauma, Shanghai Jiaotong University School of Medicine, 1630 Dongfang Road, Shanghai, 200127, China Johns Hopkins University School of Medicine, 1800 Orleans St. Sheikh Zayed Tower, Baltimore, MD 21287, United States Stanford Neuroscience Health Center, 213 Quarry Rd 4th Fl MC 5958, Palo Alto, CA 94304, United States Department of Neurosurgery, Pasteur Drive, Room R205, Edward’s Building, MC 5327, Stanford, CA 94305, United States Department of Neurological Surgery, School of Medicine, Case Western Reserve University, 11100 Euclid Avenue, HAN 5042, Cleveland, OH 44106, United States Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke’s Hospital and University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB20QQ, United Kingdom Department of Neurological Sciences, Christian Medical College, Ida Scudder Road, Vellore, Tamil Nadu, India Vivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, 6400 Fannin St, Suite 2800, Houston, TX 77030, United States University of California San Francisco, San Francisco General Hospital and Trauma Center, 1001 Potrero Ave., Bldg 1, Room 101, San Francisco, CA 94110, United States Neurology, K-11, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, United States Division of Anaesthesia, University of Cambridge and Addenbrooke’s Hospital, Addenbrooke’s Hospital, Hills Road, Box 93, Cambridge, CB2 0QQ, United Kingdom Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Herestraat 49, Box 7003 63, Leuven, 3000, Belgium Oakland University William Beaumont School of Medicine, Beaumont Health, Michigan Head and Spine Institute, Southfield, MI, United States Department of Intensive Care Medicine, CHUV-Lausanne University Hospital, University of Lausanne, Faculty of Biology and Medicine, Lausanne, Switzerland Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States Vanderbilt University Medical Center, Nashville, United States Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States Department of Neurosurgery, Alfred Hospital, Melbourne, Australia Department of Surgery, Monash University, Melbourne, Australia INUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia MEDITECH Foundation, Clinical Research, Calle 7-A # 44-95, Cali, 760036, Colombia University Hospital Vall D’Hebron, Barcelona, Spain Department of Neurosurgery, Humanitas University and Research Hospital, Milan, Italy World Federation of Neurosurgical Societies, Nyon, Switzerland University of Pittsburgh Medical Center, 3550 Terrace St, Room 646, Pittsburgh, PA 15261, United States Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, 1001 Potrero Ave., Ward 3A, San Francisco, CA 94110, United States Department of Physiopathology and Transplantation, Milan University, Milan, Italy Neuroscience Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Intensive Care, Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium Department of Neurological Surgery, Penn State University Milton S. Hershey Medical Center, 30 Hope Dr., Suite 1200 | Building B, Hershey, PA 17033, United States Suruchi Bhargava Chair in Spinal Cord and Brain Regeneration Research, University of Ottawa, The Ottawa Hospital, C2 Neurosciences Unit, The Ottawa Hosptial, Civic Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada Department of Neurosurgery, Donald and Barbara Zucker School of Medicine At Hofstra/Northwell North, Shore University Hospital, 300 Community Drive, 9 Tower, Manhasset, NY, United States Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, Santa Monica, United States Posadas Hospital, Buenos Aires, Argentina Emory University School of Medicine, 49 Jesse Hill Jr Dr, Atlanta, GA 30303, United States School of Medicine and Dentistry, University of Rochester Medical Center, 601 Elmwood Ave, Box 655C, Rochester, NY 14642, United States Section of Neurosurgery, University of Manitoba, GB1, 820 Sherbrook Street, Winnipeg, MB R3A 1R9, Canada Cited By :185 Export Date: 1 February 2024 CODEN: ICMED Correspondence Address: Hawryluk, G.W.J.; Section of Neurosurgery, GB1, 820 Sherbrook Street, Canada; email: ghawryluk@hsc.mb.ca AB - Current guidelines for the treatment of adult severe traumatic brain injury (sTBI) consist of high-quality evidence reports, but they are no longer accompanied by management protocols, as these require expert opinion to bridge the gap between published evidence and patient care. We aimed to establish a modern sTBI protocol for adult patients with both intracranial pressure (ICP) and brain oxygen monitors in place.Our consensus working group consisted of 42 experienced and actively practicing sTBI opinion leaders from six continents. Having previously established a protocol for the treatment of patients with ICP monitoring alone, we addressed patients who have a brain oxygen monitor in addition to an ICP monitor. The management protocols were developed through a Delphi-method-based consensus approach and were finalized at an in-person meeting.We established three distinct treatment protocols, each with three tiers whereby higher tiers involve therapies with higher risk. One protocol addresses the management of ICP elevation when brain oxygenation is normal. A second addresses management of brain hypoxia with normal ICP. The third protocol addresses the situation when both intracranial hypertension and brain hypoxia are present. The panel considered issues pertaining to blood transfusion and ventilator management when designing the different algorithms.These protocols are intended to assist clinicians in the management of patients with both ICP and brain oxygen monitors but they do not reflect either a standard-of-care or a substitute for thoughtful individualized management. These protocols should be used in conjunction with recommendations for basic care, management of critical neuroworsening and weaning treatment recently published in conjunction with the Seattle International Brain Injury Consensus Conference. LA - English DB - MTMT ER - TY - JOUR AU - Steyerberg, Ewout W AU - Wiegers, Eveline AU - Sewalt, Charlie AU - Büki, András AU - Citerio, Giuseppe AU - De Keyser, Véronique AU - Ercole, Ari AU - Kunzmann, Kevin AU - Lanyon, Linda AU - Lecky, Fiona AU - Lingsma, Hester AU - Manley, Geoffrey AU - Nelson, David AU - Peul, Wilco AU - Stocchetti, Nino AU - von Steinbüchel, Nicole AU - Vande Vyvere, Thijs AU - Verheyden, Jan AU - Wilson, Lindsay AU - Maas, Andrew I R AU - Menon, David K ED - Ackerlund, Cecilia / Collaborator ED - Amrein, Krisztina / Collaborator ED - Andelic, Nada / Collaborator ED - Andreassen, Lasse / Collaborator ED - Anke, Audny / Collaborator ED - Antoni, Anna / Collaborator ED - Audibert, Gérard / Collaborator ED - Auslands, Kaspars / Collaborator ED - Azouvi, Philippe / Collaborator ED - Azzolini, Maria Luisa / Collaborator ED - Badenes, Rafael / Collaborator ED - Bartels, Ronald / Collaborator ED - Barzó, Pál / Collaborator ED - Beauvais, Romuald / Collaborator ED - Beer, Ronny / Collaborator ED - Bellander, Bo-Michael / Collaborator ED - Belli, Antonio / Collaborator ED - Benali, Habib / Collaborator ED - Berardino, Maurizio / Collaborator ED - Beretta, Luigi / Collaborator ED - Blaabjerg, Morten / Collaborator ED - Bragge, Peter / Collaborator ED - Brazinova, Alexandra / Collaborator ED - Brinck, Vibeke / Collaborator ED - Brooker, Joanne / Collaborator ED - Brorsson, Camilla / Collaborator ED - Buki, Andras / Collaborator ED - Bullinger, Monika / Collaborator ED - Cabeleira, Manuel / Collaborator ED - Caccioppola, Alessio / Collaborator ED - Calappi, Emiliana / Collaborator ED - Calvi, Maria Rosa / Collaborator ED - Cameron, Peter / Collaborator ED - Carbayo Lozano, Guillermo / Collaborator ED - Carbonara, Marco / Collaborator ED - Castaño-León, Ana M / Collaborator ED - Chevallard, Giorgio / Collaborator ED - Chieregato, Arturo / Collaborator ED - Cnossen, Maryse / Collaborator ED - Coburn, Mark / Collaborator ED - Coles, Jonathan / Collaborator ED - Cooper, Jamie D / Collaborator ED - Correia, Marta / Collaborator ED - Čović, Amra / Collaborator ED - Curry, Nicola / Collaborator ED - Czeiter, Endre / Collaborator ED - Czosnyka, Marek / Collaborator ED - Dahyot-Fizelier, Claire / Collaborator ED - Dawes, Helen / Collaborator ED - Degos, Vincent / Collaborator ED - Della Corte, Francesco / Collaborator ED - den Boogert, Hugo / Collaborator ED - Depreitere, Bart / Collaborator ED - Dijkland, Simone / Collaborator ED - Đilvesi, Đula / Collaborator ED - Dixit, Abhishek / Collaborator ED - Donoghue, Emma / Collaborator ED - Dreier, Jens / Collaborator ED - Dulière, Guy-Loup / Collaborator ED - Ercole, Ari / Collaborator ED - Esser, Patrick / Collaborator ED - Ezer, Erzsébet / Collaborator ED - Fabricius, Martin / Collaborator ED - Feigin, Valery L / Collaborator ED - Foks, Kelly / Collaborator ED - Frisvold, Shirin / Collaborator ED - Furmanov, Alex / Collaborator ED - Gagliardo, Pablo / Collaborator ED - Galanaud, Damien / Collaborator ED - Gantner, Dashiell / Collaborator ED - Gao, Guoyi / Collaborator ED - George, Pradeep / Collaborator ED - Ghuysen, Alexandre / Collaborator ED - Giga, Lelde / Collaborator ED - Glocker, Ben / Collaborator ED - Golubović, Jagoš / Collaborator ED - Gomez, Pedro A / Collaborator ED - Gratz, Johannes / Collaborator ED - Gravesteijn, Benjamin / Collaborator ED - Grossi, Francesca / Collaborator ED - Gruen, Russell L / Collaborator ED - Gupta, Deepak / Collaborator ED - Haagsma, Juanita A / Collaborator ED - Haitsma, Iain / Collaborator ED - Helbok, Raimund / Collaborator ED - Helseth, Eirik / Collaborator ED - Horton, Lindsay / Collaborator ED - Huijben, Jilske / Collaborator ED - Hutchinson, Peter J / Collaborator ED - Jacobs, Bram / Collaborator ED - Jankowski, Stefan / Collaborator ED - Jarrett, Mike / Collaborator ED - Jiang, Ji-Yao / Collaborator ED - Jones, Kelly / Collaborator ED - Karan, Mladen / Collaborator ED - Kolias, Angelos G / Collaborator ED - Kompanje, Erwin / Collaborator ED - Kondziella, Daniel / Collaborator ED - Koraropoulos, Evgenios / Collaborator ED - Koskinen, Lars-Owe / Collaborator ED - Kovács, Noémi / Collaborator ED - Lagares, Alfonso / Collaborator ED - Lanyon, Linda / Collaborator ED - Laureys, Steven / Collaborator ED - Lefering, Rolf / Collaborator ED - Legrand, Valerie / Collaborator ED - Lejeune, Aurelie / Collaborator ED - Levi, Leon / Collaborator ED - Lightfoot, Roger / Collaborator ED - Lozano, Angels / Collaborator ED - Maegele, Marc / Collaborator ED - Majdan, Marek / Collaborator ED - Manara, Alex / Collaborator ED - Maréchal, Hugues / Collaborator ED - Martino, Costanza / Collaborator ED - Mattern, Julia / Collaborator ED - McMahon, Catherine / Collaborator ED - Melegh, Béla / Collaborator ED - Menovsky, Tomas / Collaborator ED - Mulazzi, Davide / Collaborator ED - Muraleedharan, Visakh / Collaborator ED - Murray, Lynnette / Collaborator ED - Nair, Nandesh / Collaborator ED - Negru, Ancuta / Collaborator ED - Newcombe, Virginia / Collaborator ED - Nieboer, Daan / Collaborator ED - Noirhomme, Quentin / Collaborator ED - Nyirádi, József / Collaborator ED - Oddo, Mauro / Collaborator ED - Oresic, Matej / Collaborator ED - Ortolano, Fabrizio / Collaborator ED - Otesile, Olubukola / Collaborator ED - Palotie, Aarno / Collaborator ED - Parizel, Paul M / Collaborator ED - Payen, Jean-François / Collaborator ED - Perera, Natascha / Collaborator ED - Perlbarg, Vincent / Collaborator ED - Persona, Paolo / Collaborator ED - Piippo-Karjalainen, Anna / Collaborator ED - Pili Floury, Sébastien / Collaborator ED - Pirinen, Matti / Collaborator ED - Ples, Horia / Collaborator ED - Polinder, Suzanne / Collaborator ED - Pomposo, Inigo / Collaborator ED - Posti, Jussi P / Collaborator ED - Puybasset, Louis / Collaborator ED - Rădoi, Andreea / Collaborator ED - Ragauskas, Arminas / Collaborator ED - Raj, Rahul / Collaborator ED - Rambadagalla, Malinka / Collaborator ED - Real, Ruben / Collaborator ED - Rhodes, Jonathan / Collaborator ED - Richardson, Sylvia / Collaborator ED - Richter, Sophie / Collaborator ED - Ripatti, Samuli / Collaborator ED - Rocka, Saulius / Collaborator ED - Roe, Cecilie / Collaborator ED - Roise, Olav / Collaborator ED - Rosand, Jonathan / Collaborator ED - Rosenfeld, Jeffrey V / Collaborator ED - Rosenlund, Christina / Collaborator ED - Rosenthal, Guy / Collaborator ED - Rossaint, Rolf / Collaborator ED - Rossi, Sandra / Collaborator ED - Rueckert, Daniel / Collaborator ED - Rusnák, Martin / Collaborator ED - Sahuquillo, Juan / Collaborator ED - Sakowitz, Oliver / Collaborator ED - Sanchez-Porras, Renan / Collaborator ED - Sándor, János / Collaborator ED - Schäfer, Nadine / Collaborator ED - Schmidt, Silke / Collaborator ED - Schoechl, Herbert / Collaborator ED - Schoonman, Guus / Collaborator ED - Schou, Rico Frederik / Collaborator ED - Schwendenwein, Elisabeth / Collaborator ED - Skandsen, Toril / Collaborator ED - Smielewski, Peter / Collaborator ED - Sorinola, Abayomi / Collaborator ED - Stamatakis, Emmanuel / Collaborator ED - Stanworth, Simon / Collaborator ED - Stevanovic, Ana / Collaborator ED - Stevens, Robert / Collaborator ED - Stewart, William / Collaborator ED - Sundström, Nina / Collaborator ED - Synnot, Anneliese / Collaborator ED - Takala, Riikka / Collaborator ED - Tamás, Viktória / Collaborator ED - Tamosuitis, Tomas / Collaborator ED - Taylor, Mark Steven / Collaborator ED - Te Ao, Braden / Collaborator ED - Tenovuo, Olli / Collaborator ED - Theadom, Alice / Collaborator ED - Thomas, Matt / Collaborator ED - Tibboel, Dick / Collaborator ED - Timmers, Marjolijn / Collaborator ED - Tolias, Christos / Collaborator ED - Trapani, Tony / Collaborator ED - Tudora, Cristina Maria / Collaborator ED - Vajkoczy, Peter / Collaborator ED - Valeinis, Egils / Collaborator ED - Vallance, Shirley / Collaborator ED - Vámos, Zoltán / Collaborator ED - van der Naalt, Joukje / Collaborator ED - Van der Steen, Gregory / Collaborator ED - van Dijck, Jeroen T J M / Collaborator ED - van Essen, Thomas A / Collaborator ED - Van Hecke, Wim / Collaborator ED - van Heugten, Caroline / Collaborator ED - Van Praag, Dominique / Collaborator ED - van Wijk, Roel P J / Collaborator ED - Vande Vyvere, Thijs / Collaborator ED - Vanhaudenhuyse, Audrey / Collaborator ED - Vargiolu, Alessia / Collaborator ED - Vega, Emmanuel / Collaborator ED - Velt, Kimberley / Collaborator ED - Verheyden, Jan / Collaborator ED - Vespa, Paul M / Collaborator ED - Vik, Anne / Collaborator ED - Vilcinis, Rimantas / Collaborator ED - Volovici, Victor / Collaborator ED - Voormolen, Daphne / Collaborator ED - Vulekovic, Petar / Collaborator ED - Wang, Kevin K W / Collaborator ED - Williams, Guy / Collaborator ED - Wilson, Lindsay / Collaborator ED - Winzeck, Stefan / Collaborator ED - Wolf, Stefan / Collaborator ED - Yang, Zhihui / Collaborator ED - Ylén, Peter / Collaborator ED - Younsi, Alexander / Collaborator ED - Zeiler, Frederick A / Collaborator ED - Zelinkova, Veronika / Collaborator ED - Ziverte, Agate / Collaborator ED - Zoerle, Tommaso / Collaborator TI - Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI : a European prospective, multicentre, longitudinal, cohort study JF - LANCET NEUROLOGY J2 - LANCET NEUROL VL - 18 PY - 2019 IS - 10 SP - 923 EP - 934 PG - 12 SN - 1474-4422 DO - 10.1016/S1474-4422(19)30232-7 UR - https://m2.mtmt.hu/api/publication/30808793 ID - 30808793 N1 - Funding Agency and Grant Number: European Union 7th Framework Programme; Hannelore Kohl Stiftung; OneMind; Integra LifeSciences Corporation; MRC [G0601025] Funding Source: UKRI Funding text: European Union 7th Framework Programme, the Hannelore Kohl Stiftung, OneMind, and Integra LifeSciences Corporation. AB - The burden of traumatic brain injury (TBI) poses a large public health and societal problem, but the characteristics of patients and their care pathways in Europe are poorly understood. We aimed to characterise patient case-mix, care pathways, and outcomes of TBI.CENTER-TBI is a Europe-based, observational cohort study, consisting of a core study and a registry. Inclusion criteria for the core study were a clinical diagnosis of TBI, presentation fewer than 24 h after injury, and an indication for CT. Patients were differentiated by care pathway and assigned to the emergency room (ER) stratum (patients who were discharged from an emergency room), admission stratum (patients who were admitted to a hospital ward), or intensive care unit (ICU) stratum (patients who were admitted to the ICU). Neuroimages and biospecimens were stored in repositories and outcome was assessed at 6 months after injury. We used the IMPACT core model for estimating the expected mortality and proportion with unfavourable Glasgow Outcome Scale Extended (GOSE) outcomes in patients with moderate or severe TBI (Glasgow Coma Scale [GCS] score ≤12). The core study was registered with ClinicalTrials.gov, number NCT02210221, and with Resource Identification Portal (RRID: SCR_015582).Data from 4509 patients from 18 countries, collected between Dec 9, 2014, and Dec 17, 2017, were analysed in the core study and from 22 782 patients in the registry. In the core study, 848 (19%) patients were in the ER stratum, 1523 (34%) in the admission stratum, and 2138 (47%) in the ICU stratum. In the ICU stratum, 720 (36%) patients had mild TBI (GCS score 13-15). Compared with the core cohort, the registry had a higher proportion of patients in the ER (9839 [43%]) and admission (8571 [38%]) strata, with more than 95% of patients classified as having mild TBI. Patients in the core study were older than those in previous studies (median age 50 years [IQR 30-66], 1254 [28%] aged >65 years), 462 (11%) had serious comorbidities, 772 (18%) were taking anticoagulant or antiplatelet medication, and alcohol was contributory in 1054 (25%) TBIs. MRI and blood biomarker measurement enhanced characterisation of injury severity and type. Substantial inter-country differences existed in care pathways and practice. Incomplete recovery at 6 months (GOSE <8) was found in 207 (30%) patients in the ER stratum, 665 (53%) in the admission stratum, and 1547 (84%) in the ICU stratum. Among patients with moderate-to-severe TBI in the ICU stratum, 623 (55%) patients had unfavourable outcome at 6 months (GOSE <5), similar to the proportion predicted by the IMPACT prognostic model (observed to expected ratio 1·06 [95% CI 0·97-1·14]), but mortality was lower than expected (0·70 [0·62-0·76]).Patients with TBI who presented to European centres in the core study were older than were those in previous observational studies and often had comorbidities. Overall, most patients presented with mild TBI. The incomplete recovery of many patients should motivate precision medicine research and the identification of best practices to improve these outcomes.European Union 7th Framework Programme, the Hannelore Kohl Stiftung, OneMind, and Integra LifeSciences Corporation. LA - English DB - MTMT ER -