Controversies in Severe Traumatic Brain Injury Management

Description

This text addresses the current levels of evidence for management of a variety of critical parameters after severe traumatic brain injury (TBI), as well as providing the reader with practical approaches to care based upon existing evidence. A broad range of topics is included, ranging from specific critical care approaches to TBI to broader questions of prognostication and philosophies of treatment. Critical care topics include, for example: the type, timing, and safety of DVT prophylaxis; the choice of sedative agents in brain-injured patients; the practical application of multimodality neuromonitoring for prevention of secondary insults and injury; and the optimal treatment of dysautonomia. Broad approaches to treatment will include concepts such as: organization of trauma systems to maximize outcomes; end-of-life decision-making with incomplete data on prognosis; the use of medications to enhance recovery in the post-acute phase, and utilizing brain-machine interfaces for the restoration of function after injury. Written by experts in the field, each chapter is organized by proposal of a commonly encountered clinical question, addressing the current evidence for a variety of treatments, outlining the relevant questions on the topic that have not been adequately addressed in the literature, summarizing the options for treatment and the level of evidence upon which each is based, and finally proposing questions yet to be addressed in the literature. The text identifies in each chapter the ongoing questions for future research relevant to the topic at hand as well as providing a comprehensive educational reference for resident and fellowship training. Front Matter ....Pages i-xii Prehospital Transportation and Optimal Utilization of Resources (Sanjay Konakondla, Shelly D. Timmons)....Pages 1-7 To Treat or Not to Treat: Early Withdrawal of Therapy and the Limits of Prognostic Ability (Young Lee, Angel Ordaz, Michael Huang, Geoffrey T. Manley)....Pages 9-16 Use of Multimodality Neuromonitoring in the Management of Traumatic Brain Injury (Justin R. Davanzo, Emily P. Sieg, J. Christopher Zacko, Shelly D. Timmons)....Pages 17-28 Choice of Intracranial Pressure Monitoring Modality: Parenchymal Monitor vs. Parenchymal Monitor with Brain Tissue Oxygen Monitor vs. External Ventricular Drain (Christian B. Ricks, David O. Okonkwo)....Pages 29-36 Oxygen Management and Prevention of Cerebral Ischemia (Ashley Ralston, M. Ross Bullock)....Pages 37-46 What Is the Optimal Sedative Regimen in Severe Traumatic Brain Injury Patients? (Bradley A. Boucher)....Pages 47-60 Fluid and Electrolyte Management: Hyperosmolar Euvolemia and the Use of Hypertonic Saline for Intracranial Hypertension (Hussain Shallwani, Justice O. Agyei, John F. Morrison, Kevin J. Gibbons)....Pages 61-74 Pituitary and Other Hormonal Derangements in Severe Traumatic Brain Injury (Courtney Pendleton, Jack Jallo)....Pages 75-82 Management to Optimal Parameters: Euboxia? (Kyle Mueller, Anthony Conte, Rocky Felbaum, Randy Bell, Shelly D. Timmons, Rocco Armonda)....Pages 83-98 Nutrition: Time to Revisit? (Rani Patal, Guy Rosenthal)....Pages 99-105 Deep Vein Thrombosis and Venous Thromboembolism Prophylaxis in Traumatic Brain Injury: Current Treatment Options and Controversies (Timothy J. Kovanda, Richard B. Rodgers)....Pages 107-116 Treatment of Anemia (Peter Le Roux)....Pages 117-143 Timing of Extracerebral Operations in Severe Traumatic Brain Injury Patients (P. B. Raksin)....Pages 145-163 Optimal Treatment of Dysautonomia (Gabriel N. Friedman, Ziev B. Moses, Ian Tafel, William B. Gormley)....Pages 165-177 Use of Consciousness-Enhancing Medications in the Traumatic Brain Injury Patient (Justin R. Davanzo, Shelly D. Timmons)....Pages 179-190 Management of Traumatic Brain Injury in the Face of Antithrombotic Medication Therapy (Jonathan H. DeAntonio, Kimberly N. Means, Sudha Jayaraman, Gretchen M. Brophy)....Pages 191-205 Use of Guidelines in the Management of Traumatic Brain Injury (Ilyas Eli, Evan Joyce, Gregory W. J. Hawryluk)....Pages 207-230 Functional Neurosurgery for Sequelae of Traumatic Brain Injury (William R. Y. Carlton Jr., Gregory J. A. Murad)....Pages 231-246 The Future of Clinical Trials in Traumatic Brain Injury (David S. Hersh, Beth M. Ansel, Howard M. Eisenberg)....Pages 247-256 Who’s My Doctor? Team-Based Management (James Leiphart, James Ecklund)....Pages 257-270 Back Matter ....Pages 271-279