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

Maryse C Cnossen; Jilske A Huijben; Mathieu van der Jagt; Victor Volovici; Thomas van Essen; Suzanne Polinder; David Nelson; Ari Ercole; Nino Stocchetti; Giuseppe Citerio; Wilco C Peul; Andrew I R Maas; David Menon; Ewout W Steyerberg; Hester F Lingsma; CENTER-TBI Participants and Investigators

doi:10.1186/s13054-017-1816-9

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

Standard

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 Participants and Investigators.

In: CRIT CARE, Vol. 21, No. 1, 06.09.2017, p. 233.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-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 Participants and Investigators 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', CRIT CARE, vol. 21, no. 1, pp. 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 Participants and Investigators (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. CRIT CARE, 21(1), 233. https://doi.org/10.1186/s13054-017-1816-9

Vancouver

Cnossen MC, Huijben JA, van der Jagt M, Volovici V, van Essen T, Polinder S et al. 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. CRIT CARE. 2017 Sep 6;21(1):233. https://doi.org/10.1186/s13054-017-1816-9

Bibtex

@article{be06991b1e1245cdb17b24e8b19ae89f,

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 = "Journal Article",

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 Participants and Investigators} and Monika Bullinger",

year = "2017",

month = sep,

day = "6",

doi = "10.1186/s13054-017-1816-9",

language = "English",

volume = "21",

pages = "233",

journal = "CRIT CARE",

issn = "1364-8535",

publisher = "Springer Science + Business Media",

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 Participants and Investigators

AU - Bullinger, Monika

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 - Journal Article

U2 - 10.1186/s13054-017-1816-9

DO - 10.1186/s13054-017-1816-9

M3 - SCORING: Journal article

C2 - 28874206

VL - 21

SP - 233

JO - CRIT CARE

JF - CRIT CARE

SN - 1364-8535

IS - 1

ER -