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Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
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Moderate traumatic brain injury, acute phase course and deviations in physiological variables: an observational study
Stine B Lund1,2,3, Kari H Gjeilo4,5, Kent G Moen6,7
1Department of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. stine.b.lund@ntnu.no.
Summary
Moderate traumatic brain injury (TBI) patients often require intensive care due to intracranial and extracranial injuries. Many experience physiological deviations, highlighting the need for specific TBI management guidelines.
Area of Science:
- Neuroscience
- Trauma Care
- Critical Care Medicine
Background:
- Moderate traumatic brain injury (TBI) presents heterogeneous clinical courses.
- Current guidelines for acute phase monitoring and care in moderate TBI are lacking.
- Significant variability exists in patient outcomes and management needs.
Purpose of the Study:
- To describe injury severity and acute phase course in moderate TBI patients.
- To identify deviations in physiological variables during the first three days post-injury.
- To inform the development of specific management guidelines for moderate TBI.
Main Methods:
- Observational study of 119 moderate TBI patients (≥16 years) over 5 years.
- Prospective collection of injury-related and acute phase data.
- Retrospective collection of deviations in six physiological variables.
Main Results:
- 86% had intracranial pathology, 61% had extracranial injuries.
- 84% admitted to ICU on day 1; 51% stayed ≥3 days.
- Patients in ICU ≥3 days had lower GCS scores and more extracranial injuries, with frequent physiological deviations (hypotension, hypoxia, hyperthermia, anemia, hyperglycemia).
Conclusions:
- Moderate TBI patients, especially those with extracranial injuries, often require prolonged ICU stays.
- Frequent physiological deviations in this group suggest inadequate monitoring or management.
- Differentiated monitoring and care strategies are needed for moderate TBI patients to improve acute phase management.
