Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury : A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations
Chesnut, Randall M. (Harborview Medical Center, University of Washington, Seattle, Washington, USA)
Aguilera, Sergio (Universidad de Valparaíso)
Buki, Andras (Örebro University, Örebro, Sweden)
Bulger, Eileen M. (University of Washington, Seattle, Washington, USA)
Citerio, Giuseppe (Fondazione IRCCS San Gerardo dei Tintori)
Cooper, D. Jamie (The Alfred Hospital, Melbourne, VIC, Australia)
Arrastia, Ramon Diaz (University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA)
Diringer, Michael (Barnes-Jewish Hospital, St Louis, Missouri, USA)
Figaji, Anthony (University of Cape Town, Observatory 7925, South Africa)
Gao, Guoyi (Shanghai Jiaotong University School of Medicine, Shanghai, China)
Geocadin, Romergryko G. (Johns Hopkins University School of Medicine, Baltimore, Maryland, USA)
Ghajar, Jamshid (Stanford Neuroscience Health Center, Palo Alto, California, USA)
Harris, Odette (Stanford University School of Medicine, Center for Academic Medicine, Stanford, California, USA)
Hawryluk, Gregory W. J. (Brain Trauma Foundation, New York City, New York, USA)
Hoffer, Alan (UH Cleveland Medical Center, Cleveland, Ohio, USA)
Hutchinson, Peter (University of Cambridge and Cambridge Biomedical Campus, Cambridge, UK)
Joseph, Mathew (Christian Medical College, Vellore, Tamil Nadu, India)
Kitagawa, Ryan (McGovern Medical School at UTHealth, Houston, Texas, USA)
Manley, Geoffrey (Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA)
Mayer, Stephan (Westchester Health Network, New York Medical College, Valhalla, New York, USA)
Menon, David K. (University of Cambridge and Addenbrooke's Hospital, Cambridge, UK)
Meyfroidt, Geert (Katholieke Universiteit te Leuven (1970-))
Michael, Daniel B. (Oakland University William Beaumont School of Medicine, Southfield, Michigan, USA)
Oddo, Mauro (University of Lausanne, Lausanne, Switzerland)
Okonkwo, David O. (University of Pittsburgh Medical Center Presbyterian, Pittsburgh, Pennsylvania, USA)
Patel, Mayur B. (Vanderbilt University Medical Center, Nashville, Tennessee, USA)
Robertson, Claudia (Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA)
Rosenfeld, Jeffrey V. (Monash University)
Rubiano, Andres M. (MEDITECH Foundation, Clinical Research, Cali, Colombia)
Sahuquillo, Juain (Hospital Universitari Vall d'Hebron)
Servadei, Franco (Humanitas University and IRCCS Humanitas Research Hospital, Milano, Italy)
Shutter, Lori (University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA)
Stein, Deborah M. (University of Maryland Medical Center, Baltimore, Maryland, USA)
Stocchetti, Nino (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (Milà, Itàlia))
Taccone, Fabio Silvio (Université Libre de Bruxelles (ULB), Brussels, Belgium)
Timmons, Shelly D. (Indiana University School of Medicine, Indianapolis, Indiana, USA)
Tsai, Eve C. (University of Ottawa, Civic Campus, Ottawa, Ontario, Canada)
Ullman, Jamie S. (North Shore University Hospital, Manhasset, New York, USA)
Videtta, Walter (Intensive Care, Posadas Hospital, Buenos Aires, Argentina)
Wright, David W. (Emory University School of Medicine, Atlanta, Georgia, USA)
Zammit, Christopher (University of Rochester Medical Center, Rochester, New York, USA)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion. We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression. Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations. Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Algorithms ; Consensus development ; Intracranial hypertension ; Intracranial pressure monitoring ; Neurocritical care ; Practice guidelines ; Traumatic brain injury
Publicat a:	Neurosurgery, Vol. 93 (may 2023) , p. 399-408, ISSN 1524-4040

DOI: 10.1227/neu.0000000000002516
PMID: 37171175

10 p, 1.4 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats