Nilsson P, Enblad P, Chambers I, Citerio G, Fiddes H, Howells T, Kiening K, Ragauskas A, Sahuquillo J, Yau Y H, Contant C, Piper I
Department of Neurosurgery, University Hospital, Uppsala, Sweden.
Acta Neurochir Suppl. 2005;95:51-3. doi: 10.1007/3-211-32318-x_11.
The aim of this study was to obtain basic knowledge about the current local conditions and neurointensive care of traumatic brain injury (TBI) in the new multi-centre collaborative BrainIT group.
The survey comprised a background part on local policies (Part A), and a case study section (Part B). The information was gathered by questionnaire followed by telephone interviews. Twenty-three BrainIT centres participated in the survey and answers from two respondents were available from 18 of the sites.
The average proportion of agreement between duplicate respondents was 0.778 (range 0.415-1.00). All BrainIT centres monitored ICP. The treatment protocols seem to have a pattern concerning escalation of treatment of intracranial hypertension: 1/ evacuation of mass lesions and head elevation; 2/ increased sedation and mannitol; 3/ hyperventilation; 4/ ventricular drainage; 5/ craniectomy and barbituates.
There seemed to be an agreement on neurointensive care policies within the BrainIT group. The suggested order of treatment was generally in accordance with published guidelines although the suggested order and combinations of different treatments varied. Variation of treatment within the range of prescribed standards provides optimal conditions for an interesting future analysis of treatment and monitoring data in reality using the BrainIT database.
本研究旨在获取有关新的多中心合作BrainIT组中创伤性脑损伤(TBI)当前当地情况及神经重症监护的基础知识。
该调查包括关于当地政策的背景部分(A部分)和一个案例研究部分(B部分)。通过问卷调查随后进行电话访谈收集信息。23个BrainIT中心参与了调查,18个站点有两位受访者的回答可供使用。
重复受访者之间的平均一致比例为0.778(范围0.415 - 1.00)。所有BrainIT中心都监测颅内压(ICP)。治疗方案在颅内高压治疗升级方面似乎有一个模式:1/清除占位性病变并抬高头部;2/增加镇静和使用甘露醇;3/过度通气;4/脑室引流;5/颅骨切除术和使用巴比妥类药物。
BrainIT组内似乎在神经重症监护政策上达成了一致。建议的治疗顺序总体上符合已发表的指南,尽管不同治疗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使用BrainIT数据库对实际治疗和监测数据进行有趣的分析提供了最佳条件。