General intensive care for patients with traumatic brain injury: An update

Chowdhury, Tumul; Kowalski, Stephen; Arabi, Yaseen M.; Dash, Hari H.

doi:10.4103/1658-354x.130742

Cited by 8 publications

(3 citation statements)

References 66 publications

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“…Optimization of physiological parameters, understanding of basic neurocritical care knowledge as well as incorporation of newer guidelines would certainly improve the outcome of the TBI patients. [28]…”

Section: Discussionmentioning

confidence: 99%

Our experience with management and outcome of isolated traumatic brain injury patients admitted in Intensive Care Unit

Para

Sarmast

Shah

et al. 2018

J Emerg Trauma Shock

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Introduction:Traumatic brain injury (TBI) is a major cause of death and disability throughout the world. Commonly used predictors of outcome both individually or in combination include age, Glasgow Coma Scale score, pupillary reactivity, early hypoxia, and hypotension. Most of the studies previously done to examine risk factors for mortality in severe TBI were done in the setting of polytrauma.Aims and Objectives:The aim and objective of this study was to do an in-depth analysis of various factors associated with the management and outcome of patients with isolated TBI admitted in an Intensive Care Unit (ICU).Materials and Methods:A total of seventy adult patients who were admitted to Intensive Critical Care Unit (ICU) with isolated TBI were selected during a 12-month period from January 2016 to December 2016. This is a prospective analytical study and parameters studied included age, sex, cause of admission classified by type of trauma, premorbid functional status, acute and chronic comorbidities, brain noncontrast computed tomography scan data, Glasgow Coma Scale (GCS), hemodynamic status, respiratory status, and mechanical ventilation, blood gases, serum electrolytes, serum glucose, hemoglobin, leukocyte and platelet counts, renal function, and urinary output.Results:The study population consisted of 46 (65.7%) males and 24 (34.2%) females. The mean age was 35.5 years (range, 18–65 years). The most common mode of trauma was road traffic accident (43.6%) followed by fall from height (35.7%). Statistically insignificant relationship (P < 0.05) was seen with sex and mode of injury among survivors and nonsurvivors; however, 61.9% of patients with age ≥40 years died (P < 0.005). Among clinical parameters at admission to ICU, low GCS, hypotension (mean arterial pressure ≤80 mmHg), hypoxia (pO2 ≤60 mmHg, spO2 ≤90 mmHg), and nonreacting pupils were significantly associated with increased mortality (P < 0.05).Conclusion:Isolated TBI still continues to have a good amount of morbidity and mortality which perhaps can be reduced by strict adherence to guidelines of management.

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Section: Discussionmentioning

confidence: 99%

Our experience with management and outcome of isolated traumatic brain injury patients admitted in Intensive Care Unit

Para

Sarmast

Shah

et al. 2018

J Emerg Trauma Shock

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“…Its unique feature is to keep the brain awake in the case of hypoxia. This advantage makes Dex unique in the type of surgery that requires intraoperative patient cooperation [ 15 ].…”

Section: Knowledge Backgroundmentioning

confidence: 99%

Feature Extraction and Small-Sample Learning of Dexmedetomidine for Neurosurgery on Postoperative Agitation in Patients with Craniocerebral Injury

Ding

Wang

2022

Computational Intelligence and Neuroscience

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Objective. To observe the controlled effect of dexmedetomidine for neurosurgery and the effect on postoperative cognitive function. The main task of this paper is to use data from a small sample. The proposed feature extraction algorithm based on the bilinear convolutional neurological network (BCNN) is based on a small sample of data. BCNN involves the simultaneous extraction of highly discriminative cross-sectional features from the input image using two parallel subnetworks. By optimizing the algorithm to minimize losses, the two subnetworks can be supervised by each other, improving the performance of the network and obtaining accurate recognition results without spending a lot of time adjusting parameters. The mean arterial pressure (MAP) and heart rate (HR) levels of cerebral oxygen metabolism were compared between the two groups before (T0), after (T1), immediately after (T2), and after intubation (T3). In the observation group, MAP and HR values at T3, arterial-internal jugular vein bulb oxygen difference [ D a − j v O 2 ] at T1, T2, and T3, cerebral oxygen uptake ( CEO 2 ) levels, and postawakening agitation scores were lower than those of the control group during the same period ( P < 0.05 ).

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“…Epidemiology data show that early intervention is a key determinant of favorable outcome in severe TBI ( 12 – 16 ). Neuromonitoring, structural imaging, and other diagnostic techniques employed in a modern neurointensive care unit (NICU) provide real-time or near real-time information about changes in cerebral metabolism, cerebral blood flow (CBF), and intracranial pressure (ICP) among other parameters ( 10 , 17 , 18 ).…”

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confidence: 99%

Bench-to-Bedside and Bedside Back to the Bench; Seeking a Better Understanding of the Acute Pathophysiological Process in Severe Traumatic Brain Injury

Agoston

2015

Front. Neurol.

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Despite substantial investments, traumatic brain injury (TBI) remains one of the major disorders that lack specific pharmacotherapy. To a substantial degree, this situation is due to lack of understanding of the pathophysiological process of the disease. Experimental TBI research offers controlled, rapid, and cost-effective means to identify the pathophysiology but translating experimental findings into clinical practice can be further improved by using the same or similar outcome measures and clinically relevant time points. The pathophysiology during the acute phase of severe TBI is especially poorly understood. In this Mini review, I discuss some of the incongruences between current clinical practices and needs versus information provided by experimental TBI research as well as the benefits of designing animal experiments with translation into clinical practice in mind.

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General intensive care for patients with traumatic brain injury: An update

Cited by 8 publications

References 66 publications

Our experience with management and outcome of isolated traumatic brain injury patients admitted in Intensive Care Unit

Our experience with management and outcome of isolated traumatic brain injury patients admitted in Intensive Care Unit

Feature Extraction and Small-Sample Learning of Dexmedetomidine for Neurosurgery on Postoperative Agitation in Patients with Craniocerebral Injury

Bench-to-Bedside and Bedside Back to the Bench; Seeking a Better Understanding of the Acute Pathophysiological Process in Severe Traumatic Brain Injury

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