Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study

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Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury : a survey in 66 neurotrauma centers participating in the CENTER-TBI study. / Cnossen, Maryse C; Huijben, Jilske A; van der Jagt, Mathieu; Volovici, Victor; van Essen, Thomas; Polinder, Suzanne; Nelson, David; Ercole, Ari; Stocchetti, Nino; Citerio, Giuseppe; Peul, Wilco C; Maas, Andrew I R; Menon, David; Steyerberg, Ewout W; Lingsma, Hester F; CENTER-TBI investigators ; Belli, Antonio (Contributor).

In: Critical care (London, England), Vol. 21, No. 1, 233, 06.09.2017.

Research output: Contribution to journalArticlepeer-review

Harvard

Cnossen, MC, Huijben, JA, van der Jagt, M, Volovici, V, van Essen, T, Polinder, S, Nelson, D, Ercole, A, Stocchetti, N, Citerio, G, Peul, WC, Maas, AIR, Menon, D, Steyerberg, EW, Lingsma, HF, CENTER-TBI investigators & Belli, A 2017, 'Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study', Critical care (London, England), vol. 21, no. 1, 233. https://doi.org/10.1186/s13054-017-1816-9

APA

Cnossen, M. C., Huijben, J. A., van der Jagt, M., Volovici, V., van Essen, T., Polinder, S., Nelson, D., Ercole, A., Stocchetti, N., Citerio, G., Peul, W. C., Maas, A. I. R., Menon, D., Steyerberg, E. W., Lingsma, H. F., CENTER-TBI investigators, & Belli, A. (2017). Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study. Critical care (London, England), 21(1), [233]. https://doi.org/10.1186/s13054-017-1816-9

Vancouver

Author

Cnossen, Maryse C ; Huijben, Jilske A ; van der Jagt, Mathieu ; Volovici, Victor ; van Essen, Thomas ; Polinder, Suzanne ; Nelson, David ; Ercole, Ari ; Stocchetti, Nino ; Citerio, Giuseppe ; Peul, Wilco C ; Maas, Andrew I R ; Menon, David ; Steyerberg, Ewout W ; Lingsma, Hester F ; CENTER-TBI investigators ; Belli, Antonio. / Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury : a survey in 66 neurotrauma centers participating in the CENTER-TBI study. In: Critical care (London, England). 2017 ; Vol. 21, No. 1.

Bibtex

@article{fc33eef3df8e472caffd970328fab211,
title = "Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: a survey in 66 neurotrauma centers participating in the CENTER-TBI study",
abstract = "BACKGROUND: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI.METHODS: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.RESULTS: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%).CONCLUSIONS: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.",
keywords = "Traumatic brain injury, Intracranial hypertension, ICP, ICU, Comparative effectiveness research, Survey",
author = "Cnossen, {Maryse C} and Huijben, {Jilske A} and {van der Jagt}, Mathieu and Victor Volovici and {van Essen}, Thomas and Suzanne Polinder and David Nelson and Ari Ercole and Nino Stocchetti and Giuseppe Citerio and Peul, {Wilco C} and Maas, {Andrew I R} and David Menon and Steyerberg, {Ewout W} and Lingsma, {Hester F} and {CENTER-TBI investigators} and Antonio Belli",
year = "2017",
month = sep,
day = "6",
doi = "10.1186/s13054-017-1816-9",
language = "English",
volume = "21",
journal = "Critical Care",
issn = "1466-609X",
publisher = "Springer",
number = "1",

}

RIS

TY - JOUR

T1 - Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury

T2 - a survey in 66 neurotrauma centers participating in the CENTER-TBI study

AU - Cnossen, Maryse C

AU - Huijben, Jilske A

AU - van der Jagt, Mathieu

AU - Volovici, Victor

AU - van Essen, Thomas

AU - Polinder, Suzanne

AU - Nelson, David

AU - Ercole, Ari

AU - Stocchetti, Nino

AU - Citerio, Giuseppe

AU - Peul, Wilco C

AU - Maas, Andrew I R

AU - Menon, David

AU - Steyerberg, Ewout W

AU - Lingsma, Hester F

AU - CENTER-TBI investigators

A2 - Belli, Antonio

PY - 2017/9/6

Y1 - 2017/9/6

N2 - BACKGROUND: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI.METHODS: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.RESULTS: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%).CONCLUSIONS: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

AB - BACKGROUND: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI.METHODS: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.RESULTS: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%).CONCLUSIONS: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.

KW - Traumatic brain injury

KW - Intracranial hypertension

KW - ICP

KW - ICU

KW - Comparative effectiveness research

KW - Survey

U2 - 10.1186/s13054-017-1816-9

DO - 10.1186/s13054-017-1816-9

M3 - Article

C2 - 28874206

VL - 21

JO - Critical Care

JF - Critical Care

SN - 1466-609X

IS - 1

M1 - 233

ER -