A randomized trial finds no benefit from therapy guided by intracranial pressure monitoring rather than clinical and radiographic signs.
Guidelines recommend intracranial pressure (ICP) monitoring in the acute management of severe traumatic brain injury (TBI). However, only observational data support this recommendation, and not all clinicians follow it. Investigators have now performed the first randomized trial of ICP monitoring in patients with severe TBI.
Taking advantage of widespread equipoise in South America regarding the benefits of ICP monitoring, the trial involved six Bolivian and Ecuadorian hospitals with intensivist-staffed ICUs, 24-hour computed tomography availability, and neurosurgical coverage. Investigators enrolled patients older than 12 years with a Glasgow Coma Scale (GCS) score of 3–8, excluding those with unsurvivable injuries or a GCS score of 3 and b…
Reviewing Author
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)
DisclosuresSpeaker’s bureauGenentech
Grant / Research supportNational Institutes of Health/National Institute of Neurological Disorders and Stroke; Michael Goldberg Stroke Research Fund
Editorial boardsPLOS One; Scientific Reports
Leadership positions in professional societiesNeurocritical Care Society (Research Committee Member)