Research Output

Intensive care management of head injured patients in Europe: a survey from the European Brain Injury Consortium.

  Objectives: (a) to describe current practice in the monitoring and treatment of moderate and severe head injuries in Europe; (b) to report on intracranial pressure and cerebral perfusion pressure monitoring, occurrence of measured and reported intracranial hypertension, and complications related to this monitoring; (c) to investigate the relationship between the severity of injury, the frequency of monitoring and management, and outcome. Methods: A three-page questionnaire comprising 60 items of information has been compiled by 67 centres in 12 European countries. Information was collected prospectively regarding all severe and moderate head injuries in adults (>16 years) admitted to neurosurgery within 24 h of injury. A total of 1005 adult head injury cases were enrolled in the study from 1 February 1995 to 30 April 1995. The Glasgow Outcome Scale was administered at 6 months. Results: Early surgery was performed in 346 cases (35%); arterial pressure was monitored invasively in 631 (68%), ICP in 346 (37%), and jugular bulb saturation in 173 (18%). Artificial ventilation was provided to 736 patients (78%). Intracranial hypertension was noted in 55% of patients in whom ICP was recorded, while it was suspected in only 12% of cases without ICP measurement. There were great differences in the use of ventilation and CPP monitoring among the centres. Mortality at 6 months was 31%. There was an association between an increased frequency of monitoring and intervention and an increased severity of injury; correspondingly, patients who more frequently underwent monitoring and ventilation had a less favourable outcome. Conclusions: In Europe there are great differences between centres in the frequency of CPP monitoring and ventilatory support applied to head-injured patients. ICP measurement disclosed a high rate of intracranial hypertension, which was not suspected in patients evaluated on a clinical basis alone. ICP monitoring was associated with a low rate of complications. Cases with severe neurological impairment, and with the worse outcome, were treated and monitored more intensively.

  • Type:

    Article

  • Date:

    01 February 2001

  • Publication Status:

    Published

  • Publisher

    Springer

  • DOI:

    10.1007/s001340000825

  • ISSN:

    1432-1238

Citation

Stocchetti, N., Penny, K. I., Dearden, M., Braakman, R., Cohaden, F., Iannotti, F., …Unterberg, A. (2001). Intensive care management of head injured patients in Europe: a survey from the European Brain Injury Consortium. Intensive care medicine. 27, 400-406. doi:10.1007/s001340000825. ISSN 1432-1238

Authors

Keywords

Head injury; Intracranial pressure; Cerebral perfusion pressure; Artificial ventilation; Outcome; Intensive care

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