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dc.contributor.authorHuijben, Jilske A.
dc.contributor.authorVolovici, Victor
dc.contributor.authorCnossen, Maryse C.
dc.contributor.authorHaitsma, Iain K.
dc.contributor.authorStocchetti, Nino
dc.contributor.authorMaas, Andrew I. R.
dc.contributor.authorMenon, David K.
dc.contributor.authorErcole, Ari
dc.contributor.authorCiterio, Giuseppe
dc.contributor.authorNelson, David
dc.contributor.authorPolinder, Suzanne
dc.contributor.authorSteyerberg, Ewout W.
dc.contributor.authorLingsma, Hester F.
dc.contributor.authorvan der Jagt, Mathieu
dc.contributor.authorVik, Anne
dc.contributor.authorAndelic, Nada
dc.contributor.authorAndreassen, Lasse
dc.contributor.authorAnke, Audny
dc.contributor.authorFrisvold, Shirin
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRoise, Olav
dc.contributor.authorSkandsen, Toril
dc.contributor.authorHåberg, Asta
dc.contributor.authorRøe, Cecilie
dc.date.accessioned2019-03-08T08:56:32Z
dc.date.available2019-03-08T08:56:32Z
dc.date.created2019-01-17T14:32:43Z
dc.date.issued2018
dc.identifier.citationCritical Care. 2018, 22 (1), 1-9.nb_NO
dc.identifier.issn1466-609X
dc.identifier.urihttp://hdl.handle.net/11250/2589290
dc.description.abstractBackground General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. Methods We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We analyzed 23 questions focused on: 1) circulatory and respiratory management; 2) fever control; 3) use of corticosteroids; 4) nutrition and glucose management; and 5) seizure prophylaxis and treatment. Results The survey was completed predominantly by intensivists (n = 33, 50%) and neurosurgeons (n = 23, 35%) from 66 centers (97% response rate). The most common cerebral perfusion pressure (CPP) target was > 60 mmHg (n = 39, 60%) and/or an individualized target (n = 25, 38%). To support CPP, crystalloid fluid loading (n = 60, 91%) was generally preferred over albumin (n = 15, 23%), and vasopressors (n = 63, 96%) over inotropes (n = 29, 44%). The most commonly reported target of partial pressure of carbon dioxide in arterial blood (PaCO2) was 36–40 mmHg (4.8–5.3 kPa) in case of controlled intracranial pressure (ICP) < 20 mmHg (n = 45, 69%) and PaCO2 target of 30–35 mmHg (4–4.7 kPa) in case of raised ICP (n = 40, 62%). Almost all respondents indicated to generally treat fever (n = 65, 98%) with paracetamol (n = 61, 92%) and/or external cooling (n = 49, 74%). Conventional glucose management (n = 43, 66%) was preferred over tight glycemic control (n = 18, 28%). More than half of the respondents indicated to aim for full caloric replacement within 7 days (n = 43, 66%) using enteral nutrition (n = 60, 92%). Indications for and duration of seizure prophylaxis varied, and levetiracetam was mostly reported as the agent of choice for both seizure prophylaxis (n = 32, 49%) and treatment (n = 40, 61%). Conclusions Practice preferences vary substantially regarding general supportive and preventive measures in TBI patients at ICUs of European neurotrauma centers. These results provide an opportunity for future comparative effectiveness research, since a more evidence-based uniformity in good practices in general ICU management could have a major impact on TBI outcome.nb_NO
dc.language.isoengnb_NO
dc.publisherBMCnb_NO
dc.rightsNavngivelse 4.0 Internasjonal*
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/deed.no*
dc.titleVariation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) studynb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.description.versionpublishedVersionnb_NO
dc.source.pagenumber1-9nb_NO
dc.source.volume22nb_NO
dc.source.journalCritical Carenb_NO
dc.source.issue1nb_NO
dc.identifier.doi10.1186/s13054-018-2000-6
dc.identifier.cristin1659496
dc.relation.projectEU/602150nb_NO
dc.description.localcode© The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.nb_NO
cristin.unitcode194,65,30,0
cristin.unitnameInstitutt for nevromedisin og bevegelsesvitenskap
cristin.ispublishedtrue
cristin.fulltextoriginal
cristin.qualitycode2


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