Chowdhury Tumul, Kowalski Stephen, Arabi Yaseen, Dash Hari Hara
Department of Anesthesiology and Perioperative Medicine, Section of Critical Care, University of Manitoba, Winnipeg, Canada.
Department of Intensive Care, King Abdul-Aziz Medical City, Riyadh, Saudi Arabia.
Saudi J Anaesth. 2014 Apr;8(2):268-75. doi: 10.4103/1658-354X.130746.
Traumatic brain injury (TBI) is a major global problem and affects approximately 10 million peoples annually; therefore has a substantial impact on the health-care system throughout the world. In this article, we have summarized various aspects of specific intensive care management in patients with TBI including the emerging evidence mainly after the Brain Trauma Foundation (BTF) 2007 and also highlighted the scope of the future therapies. This review has involved the relevant clinical trials and reviews (from 1 January 2007 to 31 March 2013), which specifically discussed about the topic. Though, BTF guideline based management strategies could provide standardized protocols for the management of patients with TBI and have some promising effects on mortality and morbidity; there is still need of inclusion of many suggestions based on various published after 2007. The main focus of majority of these trials remained to prevent or to treat the secondary brain injury. The future therapy will be directed to treat injured neurons and may benefit the outcome. There is also urgent need to develop some good prognostic indicators as well.
创伤性脑损伤(TBI)是一个重大的全球性问题,每年影响约1000万人;因此对全球医疗保健系统产生重大影响。在本文中,我们总结了TBI患者特定重症监护管理的各个方面,包括主要在脑创伤基金会(BTF)2007年之后出现的新证据,并强调了未来治疗的范围。本综述涉及相关临床试验和综述(2007年1月1日至2013年3月31日),这些文献专门讨论了该主题。尽管基于BTF指南的管理策略可为TBI患者的管理提供标准化方案,并对死亡率和发病率产生一些有前景的效果;但仍需要纳入2007年之后发表的各种文献中的许多建议。这些试验大多主要关注预防或治疗继发性脑损伤。未来的治疗将针对受损神经元,可能改善预后。迫切需要开发一些良好的预后指标。