@article{ref1,
title="A consensus-based management protocol for the treatment of severe traumatic brain injury based on imaging and clinical examination for use when intracranial pressure monitoring is not employed",
journal="Journal of neurotrauma",
year="2020",
author="Chesnut, Randall and Temkin, Nancy and Videtta, Walter and Petroni, Gustavo and Lujan, Silvia and Pridgeon, James and Dikmen, Sureyya and Chaddock, Kelley and Barber, Jason and Machamer, Joan and Guadagnoli, Nahuel and Hendrickson, Peter and Aguilera, Sergio and Alanis, Victor and Bello Quezada, Manuel Enrique and Bautista Coronel, Ermitano and Bustamante, Luis Alberto and Cacciatroi, Armando and Carricondo, Carlos Javier and Carvajal, Felipe and Davila, Rafael and Dominguez, Mario and Figueroa, Jairo Antonio and Fillipi, Maria Martha and Godoy, Daniel and Gomez, Delia Cristina and Lacerda Gallardo, Angel Jesús and Guerra Garcia, Juan Antonio and Zerain, Gustavo la Fuente and Lavendez Cuientas, Luis Arturo and Lequipe, Cecilio and Grajales Yuca, Gerardo Vicente and Jibaja Vega, Manuel and Kessler, Michael Eduardo and Lopez Delgado, Hubiel J. and Sandi Lora, Freddy and Mazzola, Anna Maria and Maldonado, Roberto Merida and Mezquia de Pedro, Natascha and Martinez Zubieta, J. Ricardo and Mijangos Mendez, Julio Cesar and Mora, Jacobo and Ochoa Parra, Johnny Marcelo and Pahnke, Perla B. and Paranhos, Jorge and Pinero, Gustavo and Rivadeneira Pilacuán, Francisco A. and Mendez Rivera, Mario Napoleon and Romero Figueroa, Ricardo Luis and Rubiano, Andrés M. and Saraguro Orozco, Alexandra Matilde and Silesky Jiménez, Juan Ignacio and Silva Naranjo, Luis Vinicio and Soler Morejon, Caridad and Urbina, Zulma",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Globally, intracranial pressure (ICP) monitoring use in severe traumatic brain injury (sTBI) is inconsistent and susceptible to resource limitations and clinical philosophies. For situations without monitoring, there is no published comprehensive management algorithm specific to identifying and treating suspected intracranial hypertension (SICH) outside of the one ad hoc protocol in the BEST TRIP trial. As part of an ongoing NIH-supported project, a consensus conference involving 43 experienced Latin American Intensivists and Neurosurgeons who routinely care for sTBI patients without ICP monitoring, refined, revised, and augmented the original BEST TRIP algorithm. Based on BEST TRIP trial data and pre-meeting polling, 11 issues were target for development. We used Delphi-based methodology to codify individual statements and the final algorithm, using a group agreement threshold of 80%. The resulting algorithm defines SICH and addresses both general management and specific treatment. SICH treatment modalities are organized into tiers to guide treatment escalation and tapering. Treatment schedules were developed to facilitate targeted management of disease severity. A decision-support model, based on the group's combined practices, is provided to guide this process. This algorithm provides the first comprehensive management algorithm for treating sTBI patients when ICP monitoring is not available. It is intended to provide a framework to guide clinical care and direct future research toward sTBI management. Due to the dearth of relevant literature, it is explicitly consensus based, and is provided solely as a resource (a &quot;consensus-based curbside consult&quot;) to assist in treating sTBI in general intensive care units in resource-limited environments.<p /> <p>Language: en</p>",
language="en",
issn="0897-7151",
doi="10.1089/neu.2017.5599",
url="http://dx.doi.org/10.1089/neu.2017.5599"
}