Traumatic brain injured patients: primum non nocere

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Dhuleep S Wijayatilake1, Dominic P D Nielsen1, Elinor Baker1

  • 1Department of Neuro Intensive Care.

Current Opinion in Anaesthesiology
|July 14, 2018
PubMed

Insights

Optimizing traumatic brain injury (TBI) care requires tailored approaches. Recent findings suggest physician-led prehospital care and specialized neurocritical units improve outcomes, challenging older management guidelines.

Area of Science:

  • Neurology
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Traumatic brain injury (TBI) is a common condition with severe consequences.
  • TBI is a spectrum of disease, necessitating individualized treatment strategies.
  • Optimal patient outcomes require updates in prehospital and neurocritical care.

Purpose of the Study:

  • To review recent advancements in prehospital management of TBI.
  • To discuss updates in neurocritical care for TBI patients.
  • To highlight the importance of personalized TBI treatment.

Main Methods:

  • Literature review of recent studies on TBI prehospital and neurocritical care.
  • Analysis of current evidence regarding TBI management guidelines.
  • Synthesis of findings on patient outcomes and treatment preferences.

Main Results:

  • Physician involvement in prehospital care may decrease mortality in TBI patients.
  • Current systolic blood pressure (SBP) targets for TBI management are being re-evaluated.
  • Specialized neurocritical care or trauma intensive care units (ICUs) are associated with better patient outcomes.
  • Serial computed tomography (CT) scans may benefit TBI management.
  • Elderly TBI patients may prioritize cognitive function over surgical intervention.

Conclusions:

  • Effective prehospital and neurocritical intensive care unit (ICU) management significantly improves TBI patient outcomes.
  • Individualized care, including patient preferences, is crucial, especially for elderly TBI patients.
Abstract

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