http://dgnews.docguide.com/does-intracranial-pressure-monitoring-improve-outcomes-severe-traumatic-brain-injury?overlay=2&
NEW
ROCHELLE, NY -- August 15, 2017 -- Use of intracranial pressure (ICP)
monitoring in patients with severe traumatic brain injury (TBI) was
associated with a significant decrease in mortality, but it did not
improve the rate of favourable outcomes, according to a study published
in the Journal of Neurotrauma.
Although ICP monitoring was linked to more aggressive therapy, the researchers concluded that current therapies cannot adequately control increased ICP.
For the study, the researchers retrospectively investigated the effects of ICP monitoring in the treatment of severe TBI using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1,091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. The subjects were divided into those treated with and treated without ICP monitoring in intensive care for severe TBI.
The rate of ICP monitoring in the treatment of severe TBI was only 28%, suggesting that use of this method has declined compared with previous studies.
The patients who received ICP monitoring had significantly higher rates of therapy with hyperventilation, hyperosmolar diuretics, sedatives, anticonvulsants, and surgery, and more intensive body temperature management. Yet there was no significant difference in the favourable outcome rate between the ICP and non-ICP monitoring groups of patients.
“We conclude that ICP monitoring and management of ICP are both important for management and care of severe TBI,” the authors wrote. “However, current therapies do not control ICP sufficiently, and more effective therapies are needed.”
“This well-reasoned retrospective analysis focuses on an issue that continues to generate controversy in relation to the care and management of traumatically brain injured patients,” wrote John T. Povlishock, PhD, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, Virginia, in an accompanying editorial. “What is of note in this communication is the fact that although those patients were aggressively managed, with concomitant ICP monitoring revealing a significant reduction in mortality, this occurred without any improvement in outcome, a finding that further highlights the continued controversy surrounding routine ICP monitoring.”
Reference: DOI: 10.1089/neu.2016.4948
SOURCE: Mary Ann Liebert, Inc.
Although ICP monitoring was linked to more aggressive therapy, the researchers concluded that current therapies cannot adequately control increased ICP.
For the study, the researchers retrospectively investigated the effects of ICP monitoring in the treatment of severe TBI using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1,091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. The subjects were divided into those treated with and treated without ICP monitoring in intensive care for severe TBI.
The rate of ICP monitoring in the treatment of severe TBI was only 28%, suggesting that use of this method has declined compared with previous studies.
The patients who received ICP monitoring had significantly higher rates of therapy with hyperventilation, hyperosmolar diuretics, sedatives, anticonvulsants, and surgery, and more intensive body temperature management. Yet there was no significant difference in the favourable outcome rate between the ICP and non-ICP monitoring groups of patients.
“We conclude that ICP monitoring and management of ICP are both important for management and care of severe TBI,” the authors wrote. “However, current therapies do not control ICP sufficiently, and more effective therapies are needed.”
“This well-reasoned retrospective analysis focuses on an issue that continues to generate controversy in relation to the care and management of traumatically brain injured patients,” wrote John T. Povlishock, PhD, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, Virginia, in an accompanying editorial. “What is of note in this communication is the fact that although those patients were aggressively managed, with concomitant ICP monitoring revealing a significant reduction in mortality, this occurred without any improvement in outcome, a finding that further highlights the continued controversy surrounding routine ICP monitoring.”
Reference: DOI: 10.1089/neu.2016.4948
SOURCE: Mary Ann Liebert, Inc.
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