Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-7479d7b7d-t6hkb Total loading time: 0 Render date: 2024-07-11T03:28:56.782Z Has data issue: false hasContentIssue false

Chapter 10 - Principles of Head Injury Intensive Care Management

Published online by Cambridge University Press:  28 April 2020

By
Martin Smith
Edited by
Peter C. Whitfield ,
Jessie Welbourne ,
Elfyn Thomas ,
Fiona Summers ,
Maggie Whyte  and
Peter J. Hutchinson
Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
Get access

Summary

Traumatic brain injury (TBI) encompasses a continuum of primary and secondary injurious processes. Primary injury describes the irreversible structural damage sustained at the time of impact. It initiates a host response which results in a cascade of biochemical, cellular and molecular events that lead to further (secondary) brain injury.1 Advances in neuromonitoring and neuroimaging techniques, in association with improved understanding of the pathophysiology of TBI, have led to the introduction of more effective critical care treatment strategies aimed at preventing or minimising secondary injury that have translated into improved outcomes for patients.

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
 , pp. 97 - 109
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

McGinn, MJ, Povlishock, JT. Pathophysiology of traumatic brain injury. Neurosurg Clin N Am 2016;27:397–407.CrossRefGoogle ScholarPubMed
Teasdale, G, Maas, A, Lecky, F, Manley, G, Stocchetti, N, Murray, G. The Glasgow Coma Scale at 40 years: standing the test of time. Lancet Neurol 2014;13:844–54.Google Scholar
Oddo, M, Villa, F, Citerio, G. Brain multimodality monitoring: an update. Curr Opin Crit Care 2012;18:111–18.CrossRefGoogle ScholarPubMed
Smith, M. Multimodality neuromonitoring in adult traumatic brain injury: a narrative review. Anesthesiology 2018;128:401–15.CrossRefGoogle ScholarPubMed
Carney, N, Totten, AM, O’Reilly, C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery 2017;80:6–15.CrossRefGoogle ScholarPubMed
Stocchetti, N, Picetti, E, Berardino, M, et al. Clinical applications of intracranial pressure monitoring in traumatic brain injury: report of the Milan consensus conference. Acta Neurochir (Wien) 2014;156:1615–22.CrossRefGoogle ScholarPubMed
Oddo, M, Levine, JM, Mackenzie, L, et al. Brain hypoxia is associated with short-term outcome after severe traumatic brain injury independently of intracranial hypertension and low cerebral perfusion pressure. Neurosurgery 2011;69:1037–45.Google Scholar
Kirkman, MA, Smith, MB. Oxygenation monitoring. Anesthesiol Clin 2016;34:537–56.Google Scholar
Okonkwo, DO, Shutter, LA, Moore, C, et al. Brain oxygen optimization in severe traumatic brain injury phase-II: a phase II randomized trial. Crit Care Med 2017;45:1907–14.CrossRefGoogle ScholarPubMed
Makarenko, S, Griesdale, DE, Gooderham, P, Sekhon, MS. Multimodal neuromonitoring for traumatic brain injury: a shift towards individualized therapy. J Clin Neurosci 2016;26:8–13.Google Scholar
Kinoshita, K. Traumatic brain injury: pathophysiology for neurocritical care. J Intensive Care 2016;4:29.CrossRefGoogle ScholarPubMed
Wijdicks, EF, Menon, DK, Smith, M. Ten things you need to know to practice neurological critical care. Intensive Care Med 2015;41:318–21.Google Scholar
Kramer, AH, Zygun, DA. Neurocritical care: why does it make a difference? Curr Opin Crit Care 2014;20:174–81.Google Scholar
McHugh, GS, Engel, DC, Butcher, I, et al. Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma 2007;24:287–93.Google Scholar
van der Jagt, M. Fluid management of the neurological patient: a concise review. Crit Care 2016;20:126.CrossRefGoogle Scholar
Gantner, D, Moore, EM, Cooper, DJ. Intravenous fluids in traumatic brain injury: what’s the solution? Curr Opin Crit Care 2014;20:385–9.Google Scholar
Asehnoune, K, Lasocki, S, Seguin, P, et al. Association between continuous hyperosmolar therapy and survival in patients with traumatic brain injury – a multicentre prospective cohort study and systematic review. Crit Care 2017;21:328.Google Scholar
Mascia, L, Zavala, E, Bosma, K, et al. High tidal volume is associated with the development of acute lung injury after severe brain injury: an international observational study. Crit Care Med 2007;35:1815–20.Google Scholar
Boone, MD, Jinadasa, SP, Mueller, A, et al. The effect of positive end-expiratory pressure on intracranial pressure and cerebral hemodynamics. Neurocrit Care 2017;26:174–81.Google Scholar
Lu, Q, Xie, Y, Qi, X, Li, X, Yang, S, Wang, Y. Is early tracheostomy better for severe traumatic brain injury? A meta-analysis. World Neurosurg 2018;Jan 11 Epub ahead of print.CrossRefGoogle Scholar
Jauch-Chara, K, Oltmanns, KM. Glycemic control after brain injury: boon and bane for the brain. Neuroscience 2014;283:202–9.CrossRefGoogle ScholarPubMed
Hermanides, J, Plummer, MP, Finnis, M, Deane, AM, Coles, JP, Menon, DK. Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis. Crit Care 2018;22:11.Google Scholar
Godoy, DA, Behrouz, R, Di Napoli, M. Glucose control in acute brain injury: does it matter? Curr Opin Crit Care 2016;22:120–7.Google ScholarPubMed
Bohman, LE, Levine, JM. Fever and therapeutic normothermia in severe brain injury: an update. Curr Opin Crit Care 2014;20:182–8.Google Scholar
Lewis, SR, Evans, DJ, Butler, AR, Schofield-Robinson, OJ, Alderson, P. Hypothermia for traumatic brain injury. Cochrane Database Syst Rev 2017;9:CD001048.Google ScholarPubMed
Andrews, PJ, Sinclair, HL, Rodriguez, A, et al. Hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med 2015;373:2403–12.CrossRefGoogle ScholarPubMed
Xu, JC, Shen, J, Shao, WZ, et al.The safety and efficacy of levetiracetam versus phenytoin for seizure prophylaxis after traumatic brain injury: a systematic review and meta-analysis. Brain Inj 2016;30:1054–61.Google Scholar
Epstein, DS, Mitra, B, O’Reilly, G, Rosenfeld, JV, Cameron, PA. Acute traumatic coagulopathy in the setting of isolated traumatic brain injury: a systematic review and meta-analysis. Injury 2014;45:819–24.CrossRefGoogle ScholarPubMed
Lelubre, C, Bouzat, P, Crippa, IA, Taccone, FS. Anemia management after acute brain injury. Crit Care 2016;20:152.Google Scholar
Robertson, CS, Hannay, HJ, Yamal, JM, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA 2014;312:36–47.CrossRefGoogle ScholarPubMed
Wang, X, Dong, Y, Han, X, Qi, XQ, Huang, CG, Hou, LJ. Nutritional support for patients sustaining traumatic brain injury: a systematic review and meta-analysis of prospective studies. PLoS One 2013;8:e58838.CrossRefGoogle ScholarPubMed
Abdel-Aziz, H, Dunham, CM, Malik, RJ, Hileman, BM. Timing for deep vein thrombosis chemoprophylaxis in traumatic brain injury: an evidence-based review. Crit Care 2015;19:96.CrossRefGoogle ScholarPubMed
Kirkman, MA, Smith, M. Intracranial pressure monitoring, cerebral perfusion pressure estimation, and ICP/CPP-guided therapy: a standard of care or optional extra after brain injury? Br J Anaesth 2014;112:35–46.Google Scholar
Badri, S, Chen, J, Barber, J, et al. Mortality and long-term functional outcome associated with intracranial pressure after traumatic brain injury. Intensive Care Med 2012;38:1800–9.Google Scholar
Balestreri, M, Czosnyka, M, Hutchinson, P, et al. Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortality after head injury. Neurocrit Care 2006;4:8–13.Google Scholar
Stocchetti, N, Maas, AI. Traumatic intracranial hypertension. N Engl J Med 2014;370:2121–30.Google Scholar
Stocchetti, N, Zanaboni, C, Colombo, A, et al. Refractory intracranial hypertension and ‘second-tier’ therapies in traumatic brain injury. Intensive Care Med 2008;34:461–7.Google Scholar
Yuan, Q, Wu, X, Sun, Y, et al. Impact of intracranial pressure monitoring on mortality in patients with traumatic brain injury: a systematic review and meta-analysis. J Neurosurg 2015;122:574–87.CrossRefGoogle ScholarPubMed
Chesnut, RM, Temkin, N, Carney, N, et al. A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 2012;367:2471–81.Google Scholar
Chesnut, RM. Intracranial pressure monitoring: headstone or a new head start: the BEST TRIP trial in perspective. Intensive Care Med 2013;39:771–4.Google Scholar
Koskinen, LO, Olivecrona, M, Grande, PO. Severe traumatic brain injury management and clinical outcome using the Lund concept. Neuroscience 2014;283:245–55.CrossRefGoogle ScholarPubMed
Needham, E, McFadyen, C, Newcombe, V, Synnot, AJ, Czosnyka, M, Menon, D. Cerebral perfusion pressure targets individualized to pressure-reactivity index in moderate to severe traumatic brain injury: a systematic review. J Neurotrauma 2017;34:963–70.Google Scholar
Smith, M. Cerebral perfusion pressure. Br J Anaesth 2015;115:488–90.Google Scholar
Kosty, JA, LeRoux, PD, Levine, J, et al. Brief report: a comparison of clinical and research practices in measuring cerebral perfusion pressure: a literature review and practitioner survey. Anesth Analg 2013;117:694–8.CrossRefGoogle ScholarPubMed
Leach, P, Childs, C, Evans, J, Johnston, N, Protheroe, R, King, A. Transfer times for patients with extradural and subdural haematomas to neurosurgery in Greater Manchester. Br J Neurosurg 2007;21:11–15.Google Scholar
Kolias, AG, Kirkpatrick, PJ, Hutchinson, PJ. Decompressive craniectomy: past, present and future. Nat Rev Neurol 2013;9:405–15.Google Scholar
Hutchinson, PJ, Kolias, AG, Timofeev, IS, et al. Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med 2016;375:1119–30.CrossRefGoogle ScholarPubMed
Stocchetti, N, Taccone, FS, Citerio, G, et al. Neuroprotection in acute brain injury: an up-to-date review. Crit Care 2015;19:186.Google Scholar
Lu, XY, Sun, H, Li, QY, Lu, PS. Progesterone for traumatic brain injury: a meta-analysis review of randomized controlled trials. World Neurosurg 2016;90:199–210.Google Scholar
Liu, WC, Wen, L, Xie, T, Wang, H, Gong, JB, Yang, XF. Therapeutic effect of erythropoietin in patients with traumatic brain injury: a meta-analysis of randomized controlled trials. J Neurosurg 2016;127(1):8-15.Google Scholar
Corral, L, Javierre, CF, Ventura, JL, Marcos, P, Herrero, JI, Manez, R. Impact of non-neurological complications in severe traumatic brain injury outcome. Crit Care 2012;16:R44.Google Scholar
Gaddam, SS, Buell, T, Robertson, CS. Systemic manifestations of traumatic brain injury. Handb Clin Neurol 2015;127:205–18.CrossRefGoogle ScholarPubMed
Krishnamoorthy, V, Mackensen, GB, Gibbons, EF, Vavilala, MS. Cardiac dysfunction after neurologic injury: what do we know and where are we going? Chest 2016;149:1325–31.Google Scholar
Anthony, DC, Couch, Y. The systemic response to CNS injury. Exp Neurol 2014;258:105–11.Google Scholar
Zygun, DA, Kortbeek, JB, Fick, GH, Laupland, KB, Doig, CJ. Non-neurologic organ dysfunction in severe traumatic brain injury. Crit Care Med 2005;33:654–60.Google Scholar
Zygun, DA, Zuege, DJ, Boiteau, PJ, Laupland, KB, Henderson, EA, Kortbeek, JB, Doig, CJ. Ventilator-associated pneumonia in severe traumatic brain injury. Neurocrit Care 2006;5:108–14.Google Scholar
Young, N, Rhodes, JK, Mascia, L, Andrews, PJ. Ventilatory strategies for patients with acute brain injury. Curr Opin Crit Care 2010;16:45–52.CrossRefGoogle ScholarPubMed
Tisdall, M, Crocker, M, Watkiss, J, Smith, M. Disturbances of sodium in critically ill adult neurologic patients: a clinical review. J Neurosurg Anesthesiol 2006;18:57–63.Google Scholar
Vespa, PM. Hormonal dysfunction in neurocritical patients. Curr Opin Crit Care 2013;19:107–12.Google Scholar
Lim, HB, Smith, M. Systemic complications after head injury: a clinical review. Anaesthesia 2007;62:474–82.Google Scholar
English, SW, Turgeon, AF, Owen, E, Doucette, S, Pagliarello, G, McIntyre, L. Protocol management of severe traumatic brain injury in intensive care units: a systematic review. Neurocrit Care 2013;18:131–42.Google Scholar
Gerber, LM, Chiu, YL, Carney, N, Hartl, R, Ghajar, J. Marked reduction in mortality in patients with severe traumatic brain injury. J Neurosurg 2013;119:1583–90.Google Scholar
Kramer, AH, Zygun, DA. Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years. Can J Anaesth 2013;60:966–75.Google Scholar
Harrison, DA, Prabhu, G, Grieve, R, et al. Risk Adjustment In Neurocritical care (RAIN) – prospective validation of risk prediction models for adult patients with acute traumatic brain injury to use to evaluate the optimum location and comparative costs of neurocritical care: a cohort study. Health Technol Assess 2013;17:vii–viii.Google Scholar
Stevens, RD, Sutter, R. Prognosis in severe brain injury. Crit Care Med 2013;41:1104–23.CrossRefGoogle ScholarPubMed
Harvey, D, Butler, J, Groves, J, et al. Management of perceived devastating brain injury after hospital admission: a consensus statement from stakeholder professional organizations. Br J Anaesth 2018;120:138–45.Google Scholar
Vedantam, A, Robertson, CS, Gopinath, SP. Clinical characteristics and temporal profile of recovery in patients with favorable outcomes at 6 months after severe traumatic brain injury. J Neurosurg 2018;129(1):234-40.Google Scholar
Smith, M. Treatment withdrawal and acute brain injury: an integral part of care. Anaesthesia 2012;67:941–5.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×