Enblad P, Nilsson P, Chambers I, Citerio G, Fiddes H, Howells T, Kiening K, Ragauskas A, Sahuquillo J, Yau Y H, Contant C, Piper I
Dept. of Neuroscience, Section of Neurosurgery, University Hospital, 75185 Uppsala, Sweden.
Intensive Care Med. 2004 Jun;30(6):1058-65. doi: 10.1007/s00134-004-2206-8. Epub 2004 Mar 16.
To obtain knowledge about the conditions and management of traumatic brain injury (TBI) in a collaborative network of Brain Information Technology centres.
The Brain IT (Brain monitoring with Information Technology) survey comprised two parts: local conditions and policies (part A), and a case study part (part B). The information was gathered by written questionnaires followed by telephone interviews.
Twenty-four Brain IT centres participated (two respondents from 18 sites).
The average proportion of agreement between duplicate respondents was 0.79 (range 0.44-1.00). All Brain IT centres monitored ICP. The reported order of treatment for intracranial hypertension was: evacuation of mass-lesions and head elevation (1), increase of sedation and Mannitol scheme (2), hyperventilation (3), ventricular drainage (4), craniectomy and pentothal coma (5), and decompressive lobectomy (6). The respondents were less prone to evacuate expansive contusions in relation to extra cerebral hematomas. The most common suggested interventions (alone or in combination) for treatment of intracranial hypertension without mass lesions was the Mannitol scheme (included in 71% of the suggestions), CSF drainage (included in 56%), hyperventilation (included in 32%), and pentothal coma (included in 22%).
The suggested management of TBI was mainly in accordance with published guidelines, although a minor proportion of the answers deviated to some extent. The suggested order and combinations of different treatment interventions varied. Variation of treatment within the range of prescribed standards provides optimal conditions for an interesting future analysis of treatment and monitoring data as collected prospectively in a Brain IT database.
在脑信息技术中心协作网络中获取有关创伤性脑损伤（TBI）的情况及管理方面的知识。
脑信息技术（Brain IT，即信息技术脑监测）调查包括两部分：当地情况与政策（A部分）以及案例研究部分（B部分）。信息通过书面问卷收集，随后进行电话访谈。
24个脑信息技术中心参与（18个地点各有两名受访者）。
重复受访者之间的平均一致比例为0.79（范围为0.44 - 1.00）。所有脑信息技术中心都监测颅内压（ICP）。报告的颅内高压治疗顺序为：清除占位性病变并抬高头部（1）、增加镇静及甘露醇方案（2）、过度通气（3）、脑室引流（4）、颅骨切除术及硫喷妥钠昏迷（5）、减压性脑叶切除术（6）。与脑外血肿相比，受访者较少倾向于清除扩展性挫伤。对于无占位性病变的颅内高压，最常见的建议干预措施（单独或联合使用）是甘露醇方案（71%的建议中包含）、脑脊液引流（56%包含）、过度通气（32%包含）以及硫喷妥钠昏迷（22%包含）。
尽管有一小部分答案在一定程度上存在偏差，但TBI的建议管理主要符合已发表的指南。不同治疗干预措施的建议顺序和组合有所不同。在规定标准范围内的治疗差异为未来有趣地分析前瞻性收集在脑信息技术数据库中的治疗和监测数据提供了最佳条件。
