ICP management in patients suffering from traumatic brain injury: a systematic review of randomized controlled trials.
Acta Neurochir (Wien)
; 159(12): 2279-2287, 2017 12.
Article
em En
| MEDLINE
| ID: mdl-29058090
ABSTRACT
BACKGROUND:
Severe traumatic brain injury (sTBI) is a major cause of morbidity and mortality. Intracranial pressure (ICP) monitoring and management form the cornerstone of treatment paradigms for sTBI in developed countries. We examine the available randomized controlled trial (RCT) data on the impact of ICP management on clinical outcomes after sTBI.METHODS:
A systematic review of the literature on ICP management following sTBI was performed to identify pertinent RCT articles.RESULTS:
We identified six RCT articles that examined whether ICP monitoring, decompressive craniectomy, or barbiturate coma improved clinical outcomes after sTBI. These studies support (1) the utility of ICP monitoring in the management of sTBI patients and (2) craniectomy and barbiturate coma as effective methods for the management of intracranial hypertension secondary to sTBI. However, despite adequate ICP control in sTBI patients, a significant proportion of surviving patients remain severely disabled.CONCLUSIONS:
If one sets the bar at the level of functional independence, then the RCT data raises questions pertaining to the utility of decompressive craniectomy and barbiturate coma in the setting of sTBI.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pressão Intracraniana
/
Hipertensão Intracraniana
/
Craniotomia
/
Lesões Encefálicas Traumáticas
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Acta Neurochir (Wien)
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos