| Literature DB >> 32013721 |
Randall M Chesnut1, Nancy Temkin1, Walter Videtta2, Gustavo Petroni3, Silvia Lujan3, Jim Pridgeon1, Sureyya Dikmen1, Kelley Chaddock1, Jason Barber1, Joan Machamer1, Nahuel Guadagnoli3, Peter Hendrickson1, Sergio Aguilera4, Victor Alanis5, Manuel Enrique Bello Quezada6, Ermitaño Bautista Coronel7, Luis Alberto Bustamante8, Armando C Cacciatori9, Carlos Javier Carricondo10, Felipe Carvajal11, Rafael Davila12, Mario Dominguez13, Jairo Antonio Figueroa Melgarejo14, Maria Martha Fillipi15, Daniel A Godoy16, Delia Cristina Gomez17, Angel J Lacerda Gallardo18, Juan Antonio Guerra Garcia19, Gustavo la Fuente Zerain20, Luis Arturo Lavadenz Cuientas21, Cecilio Lequipe22, Gerardo Vicente Grajales Yuca23, Manuel Jibaja Vega24, Michael Eduardo Kessler25, Hubiel J López Delgado26, Freddy Sandi Lora27, Ana Maria Mazzola28, Roberto Merida Maldonado29, Natascha Mezquia de Pedro30, J Ricardo Martínez Zubieta31, Julio C Mijangos Méndez32, Jacobo Mora12, Johnny Marcelo Ochoa Parra33, Perla B Pahnke34, Jorge Paranhos35, Gustavo R Piñero36, Francisco A Rivadeneira Pilacuán37, Mario Napoleon Mendez Rivera38, Ricardo Luis Romero Figueroa39, Andres M Rubiano40, Alexandra Matilde Saraguro Orozco41, Juan Ignacio Silesky Jiménez42, Luis Silva Naranjo43, Caridad Soler Morejon44, Zulma Urbina14.
Abstract
Globally, intracranial pressure (ICP) monitoring use in severe traumatic brain injury (sTBI) is inconsistent and susceptible to resource limitations and clinical philosophies. For situations without monitoring, there is no published comprehensive management algorithm specific to identifying and treating suspected intracranial hypertension (SICH) outside of the one ad hoc Imaging and Clinical Examination (ICE) protocol in the Benchmark Evidence from South American Trials: Treatment of Intracranial Pressure (BEST:TRIP) trial. As part of an ongoing National Institutes of Health (NIH)-supported project, a consensus conference involving 43 experienced Latin American Intensivists and Neurosurgeons who routinely care for sTBI patients without ICP monitoring, refined, revised, and augmented the original BEST:TRIP algorithm. Based on BEST:TRIP trial data and pre-meeting polling, 11 issues were targeted for development. We used Delphi-based methodology to codify individual statements and the final algorithm, using a group agreement threshold of 80%. The resulting CREVICE (Consensus REVised ICE) algorithm defines SICH and addresses both general management and specific treatment. SICH treatment modalities are organized into tiers to guide treatment escalation and tapering. Treatment schedules were developed to facilitate targeted management of disease severity. A decision-support model, based on the group's combined practices, is provided to guide this process. This algorithm provides the first comprehensive management algorithm for treating sTBI patients when ICP monitoring is not available. It is intended to provide a framework to guide clinical care and direct future research toward sTBI management. Because of the dearth of relevant literature, it is explicitly consensus based, and is provided solely as a resource (a "consensus-based curbside consult") to assist in treating sTBI in general intensive care units in resource-limited environments.Entities:
Keywords: ICP monitoring, intracranial hypertension; global health; neurocritical care; sTBI
Year: 2020 PMID： 32013721 PMCID： PMC7249475 DOI： 10.1089/neu.2017.5599
Source DB: PubMed Journal: J Neurotrauma ISSN： 0897-7151 Impact factor: 5.269