Current controversies in the management of patients with severe traumatic brain injury.

Abstract:

BACKGROUND:Traumatic brain injury is a major cause of mortality and morbidity, particularly among young men. The efficacy and safety of most of the interventions used in the management of patients with traumatic brain injury remain unproven. Examples include the 'cerebral perfusion pressure-targeted' and 'volume-targeted' management strategies for optimizing cerebrovascular haemodynamics and specific interventions, such as hyperventilation, osmotherapy, cerebrospinal fluid drainage, barbiturates, decompressive craniectomy, therapeutic hypothermia, normobaric hyperoxia and hyperbaric oxygen therapy. METHODS:A review of the literature was performed to examine the evidence base behind each intervention. RESULTS:There is no class I evidence to support the routine use of any of the therapies examined. CONCLUSION:Well-designed, large, randomized controlled trials are needed to determine therapies that are safe and effective from those that are ineffective or harmful.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Adamides AA,Winter CD,Lewis PM,Cooper DJ,Kossmann T,Rosenfeld JV

doi

10.1111/j.1445-2197.2006.03674.x

subject

Has Abstract

pub_date

2006-03-01 00:00:00

pages

163-74

issue

3

eissn

1445-1433

issn

1445-2197

pii

ANS

journal_volume

76

pub_type

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