Acta Neurochirurgica

, Volume 159, Issue 12, pp 2279–2287 | Cite as

ICP management in patients suffering from traumatic brain injury: a systematic review of randomized controlled trials

  • Peter Abraham
  • Robert C. Rennert
  • Brandon C. Gabel
  • Jayson A. Sack
  • Navaz Karanjia
  • Peter Warnke
  • Clark C. Chen
Review Article - Brain Injury

Abstract

Background

Severe traumatic brain injury (sTBI) is a major cause of morbidity and mortality. Intracranial pressure (ICP) monitoring and management form the cornerstone of treatment paradigms for sTBI in developed countries. We examine the available randomized controlled trial (RCT) data on the impact of ICP management on clinical outcomes after sTBI.

Methods

A systematic review of the literature on ICP management following sTBI was performed to identify pertinent RCT articles.

Results

We identified six RCT articles that examined whether ICP monitoring, decompressive craniectomy, or barbiturate coma improved clinical outcomes after sTBI. These studies support (1) the utility of ICP monitoring in the management of sTBI patients and (2) craniectomy and barbiturate coma as effective methods for the management of intracranial hypertension secondary to sTBI. However, despite adequate ICP control in sTBI patients, a significant proportion of surviving patients remain severely disabled.

Conclusions

If one sets the bar at the level of functional independence, then the RCT data raises questions pertaining to the utility of decompressive craniectomy and barbiturate coma in the setting of sTBI.

Keywords

Traumatic brain injury Intracranial pressure Decompressive craniectomy 

Notes

Compliance with ethical standards

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethics approval/informed consent

This literature review did not involve direct human procedures. This article does not contain any studies with human participants performed by any of the authors. For this type of study formal consent is not required.

Supplementary material

701_2017_3363_MOESM1_ESM.docx (59 kb)
ESM 1(DOCX 58 kb)

References

  1. 1.
    Agrawal A, Coronado VG, Bell JM, Baisakhiya N, Kakani A, Galwankar S, Dwivedi S (2014) Characteristics of patients who died from traumatic brain injury in two rural hospital emergency Departments in Maharashtra, India, 2007-2009. Int J Crit Illn Inj Sci 4:293–297CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Andrews PJD, Sinclair HL, Rodriguez A, Harris BA, Battison CG, Rhodes JKJ, Murray GD, Eurotherm Trial C, Noble D, Galt S, Taylor J, Addison J, Wallis C, Paterson R, Harris G, Mullan B, Quinn V, Bannon L, Gordon A, Templeton M, Wilson R, Thomas E, McMillan H, Tantam K, Gratrix A, Smith N, Martinson V, Barrera-Groba C, Littlejohn I, Spurling G, Hopkins P, Casboult S, Hadfield D, McKinlay J, Beardow Z, Elliot S, Jain R, Bellini A, McCluskey T, Harvey D, Chikhani M, Bolland A, Waldmann C, Jacques N, Prowse H, Turnbull D, Eapen G, Birchall K, Verma V, Creary T, Niebrzegowska E, Owen T, Baldwin J, Williams A, Thompson C, Salt R, Cartlidge D, Vincent A, Calder V, Scott C, Ferris P, Roberts J, Evans T, Burgess N, Della Torre V, Mellinghoff J, Stotz M, Hauer V, Ochelli-Okpue A, McMahon C, Tweedie I, Murray L, Bassford C, Ward G, McCauley M, Wise M, Palmer N, Cole J, Damas F, Xavier N, Duliere G-L, Simoens G, Biston P, Joosten A, Simon M, Antoine A, Zieppen B, Bulpa P, Dive A, Bouhon S, Taccone F, Vincent J-L, Durand D, Spapen H, Troubleyn J, Van Malderen C, Toome V, Sillaots P, Koger I, Stuttmann R, Jakubetz J, Langer S, Michalia M, Clouva-Molyvdas P-M, Vassiliadis I, Nanas S, Douka L, Dimopolous S, Pneumatikos I, Dragoumanis C, Kouliatsis G, Nakos G, Kostanti E, Zakynthinos E, Makris D, Palli E, Koukoulitsios G, Tsikritsaki K, Kalogeromitros A, Nagy E, Lampiri C, Valtoy M, Barzo P, Kis D, Fulop B, Gupta D, Bindra A, Breen D, Barry J, Neau E, Spoto M, Fusilli N, Malossini S, Antonelli M, Caricato A, Tersali A, Seabra F, Aragao I, Antunes R, Petrikov S, Titova J, Solodov A, Al-Jabbary A, Deeb A, Richi H, del Campo MM, Casado JMT, Perez EB, Perez AZ, Diez MA, Echeverri SO, Blesa A, Romero F, Sanchez M, van der Jagt M, Haitsma I, van Duijn D, Dennesen P, Koole M, Krishnareddy K, Hegazi M, Sharma BS (2015) Hypothermia for intracranial hypertension after traumatic brain injury. N Engl J Med 373:2403–2412CrossRefPubMedGoogle Scholar
  3. 3.
    Brain Trauma Foundation, American Association of Neurological Surgeons, Congress of Neurological Surgeons (2007) Guidelines for the management of severe traumatic brain injury. J Neurotrauma 24(Suppl 1):S1–106Google Scholar
  4. 4.
    Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, Bratton SL, Chesnut R, Harris OA, Kissoon N, Rubiano AM, Shutter L, Tasker RC, Vavilala MS, Wilberger J, Wright DW, Ghajar J (2017) Guidelines for the Management of Severe Traumatic Brain Injury, fourth edition. Neurosurgery 80:6–15PubMedGoogle Scholar
  5. 5.
    Carter BS, Ogilvy CS, Candia GJ, Rosas HD, Buonanno F (1997) One-year outcome after decompressive surgery for massive nondominant hemispheric infarction. Neurosurgery 40:1168–1175 discussion 1175-1166 CrossRefPubMedGoogle Scholar
  6. 6.
    Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, Petroni G, Lujan S, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T, Global Neurotrauma Research G (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:2471–2481CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Cooper DJ, Rosenfeld JV, Murray L, Arabi YM, Davies AR, D’Urso P, Kossmann T, Ponsford J, Seppelt I, Reilly P, Wolfe R, DECRA Trial Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364:1493–1502CrossRefPubMedGoogle Scholar
  8. 8.
    Cremer OL, van Dijk GW, van Wensen E, Brekelmans GJF, Moons KGM, Leenen LPH, Kalkman CJ (2005) Effect of intracranial pressure monitoring and targeted intensive care on functional outcome after severe head injury. Crit Care Med 33:2207–2213CrossRefPubMedGoogle Scholar
  9. 9.
    Dang Q, Simon J, Catino J, Puente I, Habib F, Zucker L, Bukur M (2015) More fateful than fruitful? Intracranial pressure monitoring in elderly patients with traumatic brain injury is associated with worse outcomes. J Surg Res 198:482–488CrossRefPubMedGoogle Scholar
  10. 10.
    Eisenberg HM, Frankowski RF, Contant CF, Marshall LF, Walker MD (1988) High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. J Neurosurg 69:15–23CrossRefPubMedGoogle Scholar
  11. 11.
    El-Matbouly M, El-Menyar A, Al-Thani H, Tuma M, El-Hennawy H, AbdulRahman H, Parchani A, Peralta R, Asim M, El-Faramawy A, Zarour A, Latifi R (2013) Traumatic brain injury in Qatar: age matters—insights from a 4-year observational study. ScientificWorldJournal 2013:354920CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Haddad SH, Arabi YM (2012) Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 20:12CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Group CBM, Group CSM (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Hutchinson PJ, Kolias AG, Timofeev IS, Corteen EA, Czosnyka M, Timothy J, Anderson I, Bulters DO, Belli A, Eynon CA, Wadley J, Mendelow AD, Mitchell PM, Wilson MH, Critchley G, Sahuquillo J, Unterberg A, Servadei F, Teasdale GM, Pickard JD, Menon DK, Murray GD, Kirkpatrick PJ, Collaborators RT (2016) Trial of Decompressive Craniectomy for traumatic intracranial hypertension. N Engl J Med 375:1119–1130CrossRefPubMedGoogle Scholar
  15. 15.
    Jalloh I, Carpenter KL, Helmy A, Carpenter TA, Menon DK, Hutchinson PJ (2015) Glucose metabolism following human traumatic brain injury: methods of assessment and pathophysiological findings. Metab Brain Dis 30:615–632CrossRefPubMedGoogle Scholar
  16. 16.
    Lee KK, Seow WT, Ng I (2006) Demographical profiles of adult severe traumatic brain injury patients: implications for healthcare planning. Singap Med J 47:31–36Google Scholar
  17. 17.
    Marshall LF, Marshall SB, Klauber MR, Clark MB, Eisenberg HM, Jane JA, Luerssen TG, Marmarou A, Foulkes MA (1991) A new classification of head injury based on computerized tomography. J Neurosurg 75(Suppl 1):S14–S20Google Scholar
  18. 18.
    Martini RP, Deem S, Treggiari MM (2013) Targeting brain tissue oxygenation in traumatic brain injury. Respir Care 58:162–172CrossRefPubMedGoogle Scholar
  19. 19.
    Melhem S, Shutter L, Kaynar A (2014) A trial of intracranial pressure monitoring in traumatic brain injury. Crit Care 18:302CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Romner B, Grände PO (2013) Traumatic brain injury: intracranial pressure monitoring in traumatic brain injury. Nat Rev Neurol 9:185–186CrossRefPubMedGoogle Scholar
  21. 21.
    Rutland-Brown W, Langlois JA, Thomas KE, Xi YL (2006) Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil 21:544–548CrossRefPubMedGoogle Scholar
  22. 22.
    Saiki RL (2009) Current and evolving management of traumatic brain injury. Crit Care Nurs Clin North Am 21:549–559CrossRefPubMedGoogle Scholar
  23. 23.
    Schwartz ML, Tator CH, Rowed DW, Reid SR, Meguro K, Andrews DF (1984) The University of Toronto head injury treatment study: a prospective, randomized comparison of pentobarbital and mannitol. Can J Neurol Sci 11:434–440CrossRefPubMedGoogle Scholar
  24. 24.
    Talving P, Karamanos E, Teixeira PG, Skiada D, Lam L, Belzberg H, Inaba K, Demetriades D (2013) Intracranial pressure monitoring in severe head injury: compliance with brain trauma foundation guidelines and effect on outcomes: a prospective study. J Neurosurg 119:1248–1254CrossRefPubMedGoogle Scholar
  25. 25.
    Traumatic Brain Injury in the United States (2010) Centers for Disease Control and Prevention. Accessed June 15th, 2016. Available from: http://www.cdc.gov/traumaticbraininjury/pdf/blue_book.pdf
  26. 26.
    Ward JD, Becker DP, Miller JD, Choi SC, Marmarou A, Wood C, Newlon PG, Keenan R (1985) Failure of prophylactic barbiturate coma in the treatment of severe head injury. J Neurosurg 62:383–388CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria 2017

Authors and Affiliations

  • Peter Abraham
    • 1
  • Robert C. Rennert
    • 1
  • Brandon C. Gabel
    • 1
  • Jayson A. Sack
    • 1
  • Navaz Karanjia
    • 1
  • Peter Warnke
    • 2
  • Clark C. Chen
    • 3
  1. 1.Department of NeurosurgeryUniversity of CaliforniaSan DiegoUSA
  2. 2.Section of NeurosurgeryUniversity of ChicagoChicagoUSA
  3. 3.Department of NeurosurgeryUniversity of Minnesota, UMMinneapolisUSA

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