Intensive Care Unit Management of Traumatic Brain Injury Patients

Abstract

Head injury or traumatic brain injury (TBI) is considered an instant epidemic in the developed world. Head injuries account for one quarter to a third of all trauma-related deaths. According to the Global Status Report on Road Safety 2018, more than 1.35 million people were killed in a single year. Out of these, 90% of the casualties occurred in developing countries, and India contributes about 11% of the total share. Until the last decade, cardiac disease, cancer, and road traffic accidents were considered the leading causes of death in our country. It is predicted that if the incidence of Road Traffic Accidents continues at the present rate, then by the end of 2025, the head injury will become the most common cause of death worldwide. The head injury patients pose a unique challenge to the treating physicians in the early period of hospitalization and the later duration of follow-up. The primary role of intensive care management is preventing and treating intracranial hypertension, which causes derangement in cerebral perfusion pressure (CPP), thereby preventing secondary brain injury. In the present review, we discuss the effective management of TBI in the critical care unit.

Posttraumatic hydrocephalus: Recent advances and new therapeutic strategies

“…Brain tissue may also experience intraparenchymal, acute subdural hemorrhage (ASH), or EDH, which may result in a variety of neurological sequelae 10 . Cerebral edema, ischemia, or gliosis are further pathological alterations that may develop following TBI 11–13 …”

Role of Hyperbaric Oxygen Therapy in Traumatic Brain Injury: A Systematic Review of Randomized Controlled Trials

“…2 Current standard care for TBI primarily involves conservative management, encompassing crucial interventions such as intracranial pressure monitoring, maintenance of hemodynamic stability, and pharmacological measures involving antihypertensives and antiepileptics. 3,4 Additionally, efforts to prevent secondary injury by minimizing factors such as hypoxia, hypercapnia, and systemic hypotension are integral components of routine TBI treatment. [5][6][7] One therapeutic option that gained attention in the context of TBI is hyperbaric oxygen therapy (HBOT).…”