[A diagnosis and treatment protocol for brain injury]

Brain injury is one of the main causes of death in 20-40-year-old persons. The main causes of fatal outcomes are progressive edema and cerebral ischemia. The strategic task of intensive care in patients with severe brain injury, who are critically ill, is to prevent and treat secondary ischemic brain damages. The major secondary damaging factors include arterial hypotension, hypoxemia, hyper- and hypocapnia, hypoosmolality, and hyperglycemia. This paper presents the advisable treatment protocol for patients with brain injury, which has been developed and used in a neurosurgical intensive care unit of the N. V, Sklifosofsky Research Institute of Emergency Care. The protocol is based on international guidelines and the authors' own studies. It outlines the basic lines of monitoring and intensive care in patients with severe brain injury.