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dc.contributor.authorHuijben, Jilske A.
dc.contributor.authorVolovici, Victor
dc.contributor.authorCnossen, Maryse C.
dc.contributor.authorHaitsma, Iain K.
dc.contributor.authorStocchetti, Nino
dc.contributor.authorMaas, Andrew I. R.
dc.contributor.authorMenon, David K.
dc.contributor.authorErcole, Ari
dc.contributor.authorCiterio, Giuseppe
dc.contributor.authorNelson, David
dc.contributor.authorPolinder, Suzanne
dc.contributor.authorSteyerberg, Ewout W.
dc.contributor.authorLingsma, Hester F.
dc.contributor.authorvan der Jagt, Mathieu
dc.contributor.authorVik, Anne
dc.contributor.authorAndelic, Nada
dc.contributor.authorAndreassen, Lasse
dc.contributor.authorAnke, Audny
dc.contributor.authorFrisvold, Shirin
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRoise, Olav
dc.contributor.authorSkandsen, Toril
dc.contributor.authorHåberg, Asta
dc.contributor.authorRøe, Cecilie
dc.date.accessioned2019-03-13T10:15:32Z
dc.date.available2019-03-13T10:15:32Z
dc.date.issued2018-04-13
dc.description.abstract<p><i>Background</i>: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers.</p> <p><i>Methods</i>: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We analyzed 23 questions focused on: 1) circulatory and respiratory management; 2) fever control; 3) use of corticosteroids; 4) nutrition and glucose management; and 5) seizure prophylaxis and treatment.</p> <p><i>Results</i>: The survey was completed predominantly by intensivists (n = 33, 50%) and neurosurgeons (n = 23, 35%) from 66 centers (97% response rate).</p> <p>The most common cerebral perfusion pressure (CPP) target was > 60 mmHg (n = 39, 60%) and/or an individualized target (n = 25, 38%). To support CPP, crystalloid fluid loading (n = 60, 91%) was generally preferred over albumin (n = 15, 23%), and vasopressors (n = 63, 96%) over inotropes (n = 29, 44%). The most commonly reported target of partial pressure of carbon dioxide in arterial blood (PaCO2) was 36–40 mmHg (4.8–5.3 kPa) in case of controlled intracranial pressure (ICP) < 20 mmHg (n = 45, 69%) and PaCO2 target of 30–35 mmHg (4–4.7 kPa) in case of raised ICP (n = 40, 62%). Almost all respondents indicated to generally treat fever (n = 65, 98%) with paracetamol (n = 61, 92%) and/or external cooling (n = 49, 74%). Conventional glucose management (n = 43, 66%) was preferred over tight glycemic control (n = 18, 28%). More than half of the respondents indicated to aim for full caloric replacement within 7 days (n = 43, 66%) using enteral nutrition (n = 60, 92%). Indications for and duration of seizure prophylaxis varied, and levetiracetam was mostly reported as the agent of choice for both seizure prophylaxis (n = 32, 49%) and treatment (n = 40, 61%).</p> <p><i>Conclusions</i>: Practice preferences vary substantially regarding general supportive and preventive measures in TBI patients at ICUs of European neurotrauma centers. These results provide an opportunity for future comparative effectiveness research, since a more evidence-based uniformity in good practices in general ICU management could have a major impact on TBI outcome.en_US
dc.descriptionSource at <a href=https://doi.org/10.1186/s13054-018-2000-6> https://doi.org/10.1186/s13054-018-2000-6</a>. Licensed <a href=http://creativecommons.org/licenses/by-nc-nd/4.0/> CC BY-NC-ND 4.0.</a>en_US
dc.identifier.citationHuijben, J.A., Volovici, V., Cnossen, M.C., Haitsma, I.K., Stocchetti, N., Maas, A.I.R., ... van der Jagt, M. (2018). Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. <i>Critical Care, 22</i>(1). https://doi.org/10.1186/s13054-018-2000-6en_US
dc.identifier.cristinIDFRIDAID 1659496
dc.identifier.doi10.1186/s13054-018-2000-6
dc.identifier.issn1466-609X
dc.identifier.issn1364-8535
dc.identifier.urihttps://hdl.handle.net/10037/14965
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalCritical Care
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-HEALTH/602150/EU/Periodic Report Summary 4 - CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI)/CENTER-TBI/en_US
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurology: 752en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752en_US
dc.subjectIntensive care uniten_US
dc.subjectTraumatic brain injuryen_US
dc.subjectGlucoseen_US
dc.subjectNutritionen_US
dc.subjectFeveren_US
dc.subjectVentilationen_US
dc.subjectBlood pressureen_US
dc.subjectSeizureen_US
dc.subjectSurveyen_US
dc.subjectEuropeen_US
dc.titleVariation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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