Specialist neurocritical care and outcome from head injury

Abstract

Specialist neurocritical care with protocol-driven therapy is associated with a significant improvement in outcome for all patients with severe head injury. Such management may also benefit patients requiring no surgical therapy, some of whom may need complex therapeutic interventions. We found it impossible to predict need for such interventions from clinical features at presentation. These data suggest that specialist critical care with ICP/CPP guided therapy may benefit patients with severe head injury.

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

“…[25][26][27] Several observational studies have suggested that an organized, protocol-based approach with emphasis on the prevention of ''secondary'' neurological insults may be associated with improved recovery. [28][29][30][31][32][33][34] Consistent with these developments, the care of neurocritical care patients in our region of Canada has evolved considerably over the past decade. There are few contemporary data assessing whether outcomes have changed.…”

Do Neurocritical Care Units Save Lives? Measuring The Impact of Specialized ICUs

“…We identified 12 studies, involving 24,520 patients, which presented original data comparing models of care for critically ill neurologic patients [3][4][5][6][7][8][9][10][11][12][13][14]. Four studies assessing subgroups derived from previously published data were excluded (see Electronic Supplementary Material) [15][16][17][18].…”

“…Two articles did not report hospital mortality rates; correspondence with the authors of each of these enabled us to obtain this information [6,11]. Five studies reported detailed outcome information, usually in the form of Glasgow Outcome Scale scores after C6 months [4,7,8,11,14]. Five of the remaining seven studies reported discharge disposition [3,6,9,10,12]; for the purposes of this study we defined discharge home (as opposed to a longterm care or rehabilitation facility) as a favorable outcome.…”

Actualizaciones en el manejo del traumatismo craneoencefálico grave

“…Asimismo, el hospital debe disponer de un área de neurocríticos con participación en el manejo inicial del paciente y entrenamiento específico 8 . Es obligado disponer de técnicas de neuroimagen de urgencia.…”