Traumatic Brain Injury
Key articles
IMPACT Study | ✓ the value of different prognostic factors in TBI ⇒ the most powerful independent prognostic variables identified were age, GCS motor score, pupil response, and CT finding (Marshall classification), labs (PT & glu) (J Neurotrauma. 2007) |
CRASH trial | ✓ effect of early steroids Rx in adults /w TBI ⇒ ↑ death compared to placebo. (Lancet 2004) |
CRASH-2 | ✓ the effects of early TXA Rx in TBI pts /w significant haemorrhage ⇒ ↓ mortality & death d/t bleeding w/o ↑ vascular occlusive events (Lancet 2010) |
DECRA | Efficacy of DC in severe TBI /w refractory ↑ ICP ⇒ DC ↓ ICP & ↓ ICU stay; assoc. /w worse fnx o/c at 6 mn. (N Engl J Med 2011) |
RESCUEicp | ✓ effectiveness of DC in pts /w TBI & refractory ↑ ICP ⇒ DC ↓ mortality; ↑ risk of severe disability & vegetative state compared to medical Tx alone. (N Engl J Med 2016) |
BEST-TRIP | ✓ ICP monitoring in pts /w severe TBI improves o/c ⇒ ICP focused Tx was not better to care based on CT and Px → routine ICP monitoring does not provide additional benefits for pts o/c (N Engl J Med 2012) |