Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review

2007 ◽  
Vol 6 (2) ◽  
pp. 104-112 ◽  
Author(s):  
Miriam M. Treggiari ◽  
Nicolas Schutz ◽  
N. David Yanez ◽  
Jacques-Andre Romand
QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A K Ali ◽  
A E Abdelbar ◽  
A R Farghaly ◽  
M K A Uthman

Abstract Background Traumatic brain injury (TBI) is among the most important public health problems associated with high healthcare and social burden and significant mortality and morbidity. Overall low income countries have the highest TBI associated mortality and morbidity. Aim of the Work Some studies have demonstrated that intracranial pressure (ICP) monitoring reduces the mortality of traumatic brain injury (TBI). But other studies have shown that ICP monitoring is associated with increased mortality. Patients and Methods Systematic review of Published English literature from 2000 to 2017. Using appropriate combinations of MeSH terms and key words, including intracranial pressure, intracranial hypertension, ICP monitor, intracranial pressure monitoring, TBI traumatic brain injury, and craniocerebral trauma. Brain Trauma Foundation guidelines, mortality. We performed this relatively wide search to include the maximum number of relevant patients. Results In total, 2552 studies were identified and screened for retrieval using the strategy described above. After careening the title and abstract, 1968 studies were excluded and 554 were retrieved and subjected to detailed evaluations. Based on the inclusion and exclusion criteria, 527 of those studies were excluded, and thus 27 studies were included in the systematic review. All included studies were published, peer-previewed papers. Conclusion ICP monitoring may play a role in decreasing the rate of electrolyte disturbances, rate of renal failure, and increasing favorable functional outcome. However, there was no significant effect for reducing the risk of hospital mortality, lowering occurrence rate of pulmonary infection, use of mechanical ventilation and duration of hospital stays. RCTs with larger sample size are necessary to further support the current results.


Author(s):  
Donald E. G. Griesdale ◽  
Asher A. Mendelson ◽  
Chris Gillis ◽  
William R. Henderson ◽  
Juan J. Ronco ◽  
...  

2010 ◽  
Vol 113 (3) ◽  
pp. 564-570 ◽  
Author(s):  
Roukoz Chamoun ◽  
Dima Suki ◽  
Shankar P. Gopinath ◽  
J. Clay Goodman ◽  
Claudia Robertson

Object Authors of several studies have implied a key role of glutamate, an excitatory amino acid, in the pathophysiology of traumatic brain injury (TBI). However, the place of glutamate measurement in clinical practice and its impact on the management of TBI has yet to be elucidated. The authors' objective in the present study was to evaluate glutamate levels in TBI, analyzing the factors affecting them and determining their prognostic value. Methods A prospective study of patients with severe TBI was conducted with an inclusion criterion of a Glasgow Coma Scale score ≤ 8 within 48 hours of injury. Invasive monitoring included intracranial pressure measurements, brain tissue PO2, jugular venous O2 saturation, and cerebral microdialysis. Patients received standard care including mass evacuation when indicated and treatment of elevated intracranial pressure values. Demographic data, CT findings, and outcome at 6 months of follow-up were recorded. Results One hundred sixty-five patients were included in the study. Initially high glutamate values were predictive of a poor outcome. The mortality rate was 30.3% among patients with glutamate levels > 20 μmol/L, compared with 18% among those with levels ≤ 20 μmol/L. Two general patterns were recognized: Pattern 1, glutamate levels tended to normalize over the monitoring period (120 hours); and Pattern 2, glutamate levels tended to increase with time or remain abnormally elevated. Patients showing Pattern 1 had a lower mortality rate (17.1 vs 39.6%) and a better 6-month functional outcome among survivors (41.2 vs 20.7%). Conclusions Glutamate levels measured by microdialysis appear to have an important role in TBI. Data in this study suggest that glutamate levels are correlated with the mortality rate and 6-month functional outcome.


Brain Injury ◽  
2015 ◽  
Vol 29 (9) ◽  
pp. 1018-1031 ◽  
Author(s):  
David W. Lawrence ◽  
Paul Comper ◽  
Michael G. Hutchison ◽  
Bhanu Sharma

Author(s):  
Asher A. Mendelson ◽  
Christopher Gillis ◽  
William Henderson ◽  
Juan J. Ronco ◽  
Donald E. Griesdale

2020 ◽  
Vol 194 ◽  
pp. 105815 ◽  
Author(s):  
Andrea Loggini ◽  
Ruth Tangonan ◽  
Faten El Ammar ◽  
Ali Mansour ◽  
Fernando D. Goldenberg ◽  
...  

Author(s):  
Asher A. Mendelson ◽  
Chris Gillis ◽  
William R. Henderson ◽  
Juan J. Ronco ◽  
Vinay Dhingra ◽  
...  

We conducted a systematic review to examine the relationship between intracranial pressure monitors (ICP) monitors and mortality in traumatic brain injury (TBI). We systematically searched for articles that met the following criteria: (1) adults patients, (2) TBI, (3) use of an ICP monitor, (4) point estimate for mortality with ICP monitoring (5) adjustment for potential confounders. Six observational studies were identified with 11,371 patients. There was marked between-study heterogeneity that precluded a pooled analysis. Patients with ICP monitors had different clinical characteristics and received more ICP targeted therapy in the ICU. Four studies found no significant relationship between ICP monitoring and survival, while the other two studies demonstrated conflicting results. Significant confounding by indication in observational studies limits the examination of isolated TBI interventions. More research should focus on interventions that affect TBI careplan systems. Further research is needed to identify which subset of severe TBI patients may benefit from ICP monitoring.


Author(s):  
Donald E.G. Griesdale ◽  
Asher A. Mendelson ◽  
Chris Gillis ◽  
William R. Henderson ◽  
Juan J. Ronco ◽  
...  

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