Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study.

Details

Serval ID
serval:BIB_CEF2C6242509
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study.
Journal
Critical care
Author(s)
Cnossen M.C., Huijben J.A., van der Jagt M., Volovici V., van Essen T., Polinder S., Nelson D., Ercole A., Stocchetti N., Citerio G., Peul W.C., Maas AIR, Menon D., Steyerberg E.W., Lingsma H.F.
Working group(s)
CENTER-TBI investigators
Contributor(s)
Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzó P., Bauerfeind U., Beer R., Belda F.J., Bellander B.M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L.S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Bučková V., Calappi E., Cameron P., Lozano G.C., Carise E., Carpenter K., Castaño-León A.M., Causin F., Chevallard G., Chieregato A., Citerio G., Cnossen M., Coburn M., Coles J., Cooper J.D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Corte F.D., Depreitere B., Ding S., Dippel D., Dizdarevic K., Dulière G.L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V.L., Feng J., Foks K., Fossi F., Francony G., Frantzén J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P.A., Grossi F., Gruen R.L., Gupta D., Haagsma J.A., Hadzic E., Haitsma I., Hartings J.A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P.J., Håberg A.K., Jacobs B., Janciak I., Janssens K., Jiang J.Y., Jones K., Kalala J.P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A.G., Kolumbán B., Kompanje E., Kondziella D., Koskinen L.O., Kovács N., Kálovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., Andrew IRM, MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Maréchal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menon D., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Mühlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyirádi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P.M., Patruno A., Payen J.F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Floury S.P., Pirinen M., Ples H., Polinder S., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorčíková V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D., de Arcaute F.R., Rusnák M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlößer B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R.F., Schwendenwein E., Schöll M., Sir Ö., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stegemann K., Steinbüchel N., Stevens R., Stewart W., Steyerberg E.W., Stocchetti N., Sundström N., Synnot A., Szabó J., Söderberg J., Taccone F.S., Tamás V., Tanskanen P., Tascu A., Taylor M.S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J.L., Tudora C.M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vyvere T.V., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P.M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vámos Z., Wade D., Wang KKW, Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler MKL, Ylén P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., de Lange S., de Ruiter GCW, den Boogert H., van Dijck J., van Essen T.A., van Heugten C., van der Jagt M., van der Naalt J.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
06/09/2017
Peer-reviewed
Oui
Volume
21
Number
1
Pages
233
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI.
A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.
The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%).
Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

Keywords
Comparative effectiveness research, ICP, ICU, Intracranial hypertension, Survey, Traumatic brain injury
Pubmed
Web of science
Open Access
Yes
Create date
22/12/2017 11:32
Last modification date
20/08/2019 15:49
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