TY  - JOUR
PY  - 2020//
TI  - 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
JO  - Journal of neurotrauma
A1  - Chesnut, Randall
A1  - Temkin, Nancy
A1  - Videtta, Walter
A1  - Petroni, Gustavo
A1  - Lujan, Silvia
A1  - Pridgeon, James
A1  - Dikmen, Sureyya
A1  - Chaddock, Kelley
A1  - Barber, Jason
A1  - Machamer, Joan
A1  - Guadagnoli, Nahuel
A1  - Hendrickson, Peter
A1  - Aguilera, Sergio
A1  - Alanis, Victor
A1  - Bello Quezada, Manuel Enrique
A1  - Bautista Coronel, Ermitano
A1  - Bustamante, Luis Alberto
A1  - Cacciatroi, Armando
A1  - Carricondo, Carlos Javier
A1  - Carvajal, Felipe
A1  - Davila, Rafael
A1  - Dominguez, Mario
A1  - Figueroa, Jairo Antonio
A1  - Fillipi, Maria Martha
A1  - Godoy, Daniel
A1  - Gomez, Delia Cristina
A1  - Lacerda Gallardo, Angel Jesús
A1  - Guerra Garcia, Juan Antonio
A1  - Zerain, Gustavo la Fuente
A1  - Lavendez Cuientas, Luis Arturo
A1  - Lequipe, Cecilio
A1  - Grajales Yuca, Gerardo Vicente
A1  - Jibaja Vega, Manuel
A1  - Kessler, Michael Eduardo
A1  - Lopez Delgado, Hubiel J.
A1  - Sandi Lora, Freddy
A1  - Mazzola, Anna Maria
A1  - Maldonado, Roberto Merida
A1  - Mezquia de Pedro, Natascha
A1  - Martinez Zubieta, J. Ricardo
A1  - Mijangos Mendez, Julio Cesar
A1  - Mora, Jacobo
A1  - Ochoa Parra, Johnny Marcelo
A1  - Pahnke, Perla B.
A1  - Paranhos, Jorge
A1  - Pinero, Gustavo
A1  - Rivadeneira Pilacuán, Francisco A.
A1  - Mendez Rivera, Mario Napoleon
A1  - Romero Figueroa, Ricardo Luis
A1  - Rubiano, Andrés M.
A1  - Saraguro Orozco, Alexandra Matilde
A1  - Silesky Jiménez, Juan Ignacio
A1  - Silva Naranjo, Luis Vinicio
A1  - Soler Morejon, Caridad
A1  - Urbina, Zulma
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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 "consensus-based curbside consult") to assist in treating sTBI in general intensive care units in resource-limited environments.<p />  <p>Language: en</p>
LA  - en
SN  - 0897-7151
UR  - http://dx.doi.org/10.1089/neu.2017.5599
ID  - ref1
ER  -