WSES consensus conference guidelines: monitoring and management of severe adult traumatic brain injury patients with polytrauma in the first 24 hours

Picetti, Edoardo; Rossi, Sandra; Abu‐Zidan, Fikri M.; Ansaloni, Luca; Armonda, Rocco A.; Baiocchi, Gian Luca; Bala, Miklosh; Balogh, Zsolt J.; Berardino, Maurizio; Biffl, Walter L.; Bouzat, Pierre; Büki, András; Ceresoli, Marco; Chesnut, Randall M.; Chiara, Osvaldo; Citerio, Giuseppe; Coccolini, Federico; Coimbra, Raúl; Saverio, Salomone Di; Fraga, Gustavo Pereira; Gupta, Deepak; Helbok, Raimund; Hutchinson, Peter J.; Kirkpatrick, Andrew W.; Kinoshita, Takahiro; Kluger, Yoram; Leppäniemi, Ari; Maas, Andrew I.R.; Maier, Ronald V.; Minardi, Francesco; Moore, Ernest E.; Myburgh, John; Okonkwo, David O.; Otomo, Yasuhiro; Rizoli, Sandro; Rubiano, Andrés M.; Sahuquillo, Juan; Sartelli, Massimo; Scalea, Thomas M.; Servadei, Franco; Stahel, Philip F.; Stocchetti, Nino; Taccone, Fabio Silvio; Tonetti, Tommaso; Velmahos, George C.; Weber, Dieter; Catena, Fausto

doi:10.1186/s13017-019-0270-1

Cited by 68 publications

(69 citation statements)

References 48 publications

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“…A disruption of the normal blood flow regulation in the central nervous system (CNS) characterizes the trauma and eventually leads to a blood flow dependent on perfusion pressure in ischemic tissue [67]. Specific hemodynamic goals for ST and STBI are defined as SBP > 110 mmHg and/or a CPP between 60 and 70 mmHg in the case of moderate/severe TBI and an MBP > 80 mmHg in case of ST [68,69]. To date, no study specifically addressed the NOM of abdominal solid organ injuries in the neurotrauma patient, and several authors have considered it an exclusion criterion from NOM [45,48,70].…”

Section: Diagnosismentioning

confidence: 99%

Liver trauma: WSES 2020 guidelines

et al. 2020

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Liver injuries represent one of the most frequent life-threatening injuries in trauma patients. In determining the optimal management strategy, the anatomic injury, the hemodynamic status, and the associated injuries should be taken into consideration. Liver trauma approach may require non-operative or operative management with the intent to restore the homeostasis and the normal physiology. The management of liver trauma should be multidisciplinary including trauma surgeons, interventional radiologists, and emergency and ICU physicians. The aim of this paper is to present the World Society of Emergency Surgery (WSES) liver trauma management guidelines.

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Section: Diagnosismentioning

confidence: 99%

Liver trauma: WSES 2020 guidelines

et al. 2020

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“…In these cases, a second CT scan is indicated, in order to exclude a worsening of the initial radiological findings [62]. Moreover, since the standardization of guidelines for each individual patient is not reliable and feasible in clinical practice, no specific indications for the positioning of I-ICP monitoring have been reported in the last Consensus Conference and in the new edition of Brain Trauma Foundation Guidelines, leaving the choice to the clinical experience [10,47].…”

Section: Invasive Icp Monitoringmentioning

confidence: 99%

Escalation therapy in severe traumatic brain injury: how long is intracranial pressure monitoring necessary?

et al. 2020

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Traumatic brain injury frequently causes an elevation of intracranial pressure (ICP) that could lead to reduction of cerebral perfusion pressure and cause brain ischemia. Invasive ICP monitoring is recommended by international guidelines, in order to reduce the incidence of secondary brain injury; although rare, the complications related to ICP probes could be dependent on the duration of monitoring. The aim of this manuscript is to clarify the appropriate timing for removal and management of invasive ICP monitoring, in order to reduce the risk of related complications and guarantee adequate cerebral autoregulatory control. There is no universal consensus concerning the duration of invasive ICP monitoring and its related complications, although the pertinent literature seems to show that the longer is the monitoring maintenance, the higher is the risk of technical issues. Besides, upon 72 h of normal ICP values or less than 72 h if the first computed tomography scan is normal (none or minimal signs of injury) and the neurological exam is available (allowing to observe variations and possible occurrence of new-onset pathological response), the removal of invasive ICP monitoring can be justified. The availability of non-invasive monitoring systems should be considered to follow up patients' clinical course after invasive ICP probe removal or for substituting the invasive monitoring in case of contraindication to its placement. Recently, optic nerve sheath diameter and straight sinus systolic flow velocity evaluation through ultrasound methods showed a good correlation with ICP values, demonstrating their potential role in place of invasive monitoring or in the early weaning phase from the invasive ICP monitoring.

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“…During the period of admission to the intensive care unit (ICU) for severe head injury, patients with multiple injuries are more likely to experience delirium than ordinary patients, under the combined influence of environmental factors, psychological factors, therapeutic measures, and disease (2,3). With the development of intensive care medicine, the initial treatment success rate of patients with severe head injuries and delirium combined with multiple injuries has been greatly improved.…”

Section: Introductionmentioning

confidence: 99%

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

Gao¹,

Duan²,

Ji³

et al. 2021

Ann Palliat Med

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Background:To analyze the levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the intensive care unit (ICU), and their prognostic value. Methods:The data of 98 patients with severe craniocerebral injury combined with delirium and multiple injuries admitted to our hospital from January 2018 to May 2019 were retrospectively analyzed as the study group. The differences in serum S100B, NSE, and CypA levels in each group were compared, and the deaths of the study group during follow-up were counted.Results: The levels of S100B, NSE, and CypA in the study group were higher than those in the control group (P<0.05). The mortality rate of the 98 patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU was 37.76%. Furthermore, the levels of S100B, NSE, and CypA in the death group were higher than those in the survival group (P<0.05). Glasgow Coma Score (GCS) score ≤5 points, Injury Severity Score (ISS) score >25 points, multiple organ dysfunction syndrome, and increased levels of S100B, NSE, and CypA were independent risk factors that affected the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU (P<0.05). The average survival times of the high S100B level group, the high NSE level group, and the high CypA level group were shorter than those of the low-level groups (P<0.05). Conclusions:The levels of S100B, NSE, and CypA in serum were closely related to the prognosis of patients with severe craniocerebral injury combined with delirium and multiple injuries transferred from the ICU. They can be used as molecular markers for predicting the prognosis of patients, and may serve as potential targets for treatment.

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WSES consensus conference guidelines: monitoring and management of severe adult traumatic brain injury patients with polytrauma in the first 24 hours

Cited by 68 publications

References 48 publications

Liver trauma: WSES 2020 guidelines

Liver trauma: WSES 2020 guidelines

Escalation therapy in severe traumatic brain injury: how long is intracranial pressure monitoring necessary?

Levels of S100 calcium binding protein B (S100B), neuron-specific enolase (NSE), and cyclophilin A (CypA) in the serum of patients with severe craniocerebral injury and multiple injuries combined with delirium transferred from the ICU and their prognostic value

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