Pathophysiology of Severe Traumatic Brain Injury

The Monitoring with Advanced Sensors, Transmission and E-Resuscitation in Traumatic Brain Injury (MASTER-TBI) collaborative: bringing data science to the ICU bedside

“…Moderate to severe traumatic brain injury (m-sTBI) is a highly complex disease 1 with major public health costs and consequences. 2 , 3 , 4 Unfortunately, despite much effort, there has not been any significant improvement in m-sTBI clinical care and/or patient outcomes in the past 20 years.…”

“… 3 , 5 Major m-sTBI trials examining surgical decompression, 6 , 7 therapeutic hypothermia, 8 , 9 osmotherapy, 10 and intracranial pressure (ICP) monitoring 11 have all failed to demonstrate an outcome benefit, suggesting that there is no single "magic bullet” for traumatic brain injury (TBI). In combination with improved understanding of TBI pathophysiology, 1 this lack of improvement in patient outcomes calls into question whether continuing to apply a uniform approach 12 , 13 to a complex, heterogeneous and dynamic condition 1 remains optimal. In response, a developing modulated approach afforded by multimodal monitoring seeks to improve patient care and outcomes through the collection and analysis of highly granular data, which should allow for the individualisation of m-sTBI therapy.…”