Articles: traumatic-brain-injuries.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jul 2024
Review[Anaesthesiological Management of Traumatic Brain Injury].
Traumatic brain injury (TBI) is the main cause of death in people < 45 years in industrial countries. Minimising secondary injury to the injured brain is the primary goal throughout the entire treatment. ⋯ Time management plays a crucial role in ensuring a safe anaesthesiologic environment while minimizing unnecessary procedures. Furthermore, growing medical drug pre-treatment demands for further knowledge e.g., in antagonization of anticoagulation.
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Practice Guideline Meta Analysis
Guidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate-Severe Traumatic Brain Injury: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society.
There is practice heterogeneity in the use, type, and duration of prophylactic antiseizure medications (ASMs) in patients with moderate-severe traumatic brain injury (TBI). ⋯ Based on GRADE criteria, we suggest that ASM or no ASM may be used in patients hospitalized with moderate-severe TBI (weak recommendation, low quality of evidence). If used, we suggest LEV over PHT/fPHT (weak recommendation, very low quality of evidence) for a short duration (≤ 7 days, weak recommendation, low quality of evidence).
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Journal of neurotrauma · Jun 2024
ReviewNoninvasive Methods for Intracranial Pressure (ICP) Monitoring in Traumatic Brain Injury Using Transcranial Doppler (TCD): A Scoping Review.
Intracranial pressure (ICP) monitoring is necessary for managing patients with traumatic brain injury (TBI). Although gold-standard methods include intraventricular or intraparenchymal transducers, these systems cannot be used in patients with coagulopathies or in those who are at high risk of catheter-related infections, nor can they be used in resource-constrained settings. Therefore, a non-invasive modality that is more widely available, cost effective, and safe would have tremendous impact. ⋯ Nevertheless, mathematical methods are associated with greater cost and complexity in their application. Formula-based methods showed promise in excluding elevated ICP, exhibiting a high negative predictive value. Therefore, TCD-derived methods could be useful in assessing ICP changes instead of absolute ICP values for high-risk patients, especially in low-resource settings.
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Review Meta Analysis
Efficacy and safety of tranexamic acid in acute traumatic brain injury: A meta-analysis of randomized controlled trials.
Tranexamic acid (TXA) holds a pivotal role in the therapeutic approach to traumatic conditions. Nevertheless, its precise influence on diminishing mortality and limiting the progression of intracranial hemorrhage (ICH) during the treatment of traumatic brain injury (TBI) remains indeterminate. ⋯ TXA did not elevate the risk of adverse event, however, the lack of reduction in mortality and the poor clinical outcomes constrain the value of clinical application. Early administration of TXA (within 3 h) may significantly decrease the likelihood of ICH growth in patients with TBI.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2024
Review[Specialized Concepts for the Management of Severe Neurotrauma].
Neurotrauma results from violence on structures of the central or peripheral nervous system and is a clinically common disease entity with high relevance for patients' long-term outcome. The application of evidence-based diagnostic and therapeutic concepts aims to minimize secondary injury and thus to improve treatment outcome. This article describes the current management of the two main injury patterns of neurotrauma - traumatic brain and spinal cord injury.