Anaesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience.
Department of Surgical Sciences and Integrated Diagnostics, Ospedale Policlinico San Martino IRCCS, Genova.
Curr Opin Crit Care. 2020 Apr;26(2):137-146. doi: 10.1097/MCC.0000000000000707.
The aim of this review is to provide an update on the pathophysiology and treatment of severe traumatic brain injury (TBI)-related complications on extracranial organs.
Extracranial complications are common and influence the outcome from TBI. Significant improvements in outcome in a sizeable proportion of patients could potentially be accomplished by improving the ability to prevent or reverse nonneurological complications such as pneumonia, cardiac and kidney failure. Prompt recognition and treatment of systemic complications is therefore fundamental to care of this patient cohort. However, the role of extracranial pathology often has been underestimated in outcome assessment since most clinicians focus mainly on intracranial lesions and injury rather than consider the systemic effects of TBI.
Robust evidence about pathophysiology and treatment of extracranial complications in TBI are lacking. Further studies are warranted to precisely understand and manage the multisystem response of the body after TBI.
本篇综述旨在阐述严重创伤性脑损伤（TBI）相关颅外器官并发症的病理生理学和治疗方法。
颅外并发症较为常见，并影响 TBI 的预后。通过提高预防或逆转肺炎、心肾衰竭等非神经并发症的能力，有可能使相当一部分患者的预后得到显著改善。因此，迅速识别和治疗全身并发症对于此类患者群体的护理至关重要。然而，由于大多数临床医生主要关注颅内病变和损伤，而不是考虑 TBI 对全身的影响，颅外病理在预后评估中的作用往往被低估。
关于 TBI 颅外并发症的病理生理学和治疗方法，目前仍缺乏有力的证据。需要进一步的研究来精确地了解和管理 TBI 后全身的多系统反应。
