External Ventricular Drain Versus Intraparenchymal Pressure Monitor in Severe Traumatic Brain Injury: A TRACK-TBI...

Area of Science:

• Neurosurgery
• Neurocritical Care
• Trauma Surgery

Background:

• Intracranial pressure (ICP) monitoring is crucial in severe traumatic brain injury (TBI).
• External ventricular drains (EVDs) and intraparenchymal monitors (IPMs) are common ICP monitoring devices with differing functionalities.
• The impact of device selection on patient outcomes in TBI remains debated.

Purpose of the Study:

• To determine if EVDs or IPMs for ICP monitoring are associated with better patient outcomes in severe TBI.
• To compare functional outcomes between patients monitored with EVDs versus IPMs.

Main Methods:

• Prospective enrollment of severe TBI patients (Glasgow Coma Scale 3-8) in the US TRACK-TBI study.
• Comparison of outcomes between patients receiving EVDs or IPMs within 24 hours of arrival.
• Propensity weighting was used to balance groups before outcome analysis.

Main Results:

• No significant difference in 6-month Glasgow Outcome Scale-Extended for TBI (GOSE-TBI) between EVD and IPM groups (median 3 for both).
• Hospital length of stay and 6-month neuropsychological outcomes were similar between groups.
• While more EVD patients were alive at discharge, this difference was not significant after propensity weighting.

Conclusions:

• ICP monitor type (EVD vs. IPM) did not significantly affect 6-month functional outcomes in severe TBI patients.
• The choice between EVDs and IPMs may not influence acute hospital or long-term functional recovery after TBI.
• Further research may clarify optimal ICP monitoring device selection in TBI management.