@article{f44017afe7b4432a9879e615602c9a07,
title = "A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)",
abstract = "Background: Current guidelines for the treatment of adult severe traumatic brain injury (sTBI) consist of high-quality evidence reports, but they are no longer accompanied by management protocols, as these require expert opinion to bridge the gap between published evidence and patient care. We aimed to establish a modern sTBI protocol for adult patients with both intracranial pressure (ICP) and brain oxygen monitors in place. Methods: Our consensus working group consisted of 42 experienced and actively practicing sTBI opinion leaders from six continents. Having previously established a protocol for the treatment of patients with ICP monitoring alone, we addressed patients who have a brain oxygen monitor in addition to an ICP monitor. The management protocols were developed through a Delphi-method-based consensus approach and were finalized at an in-person meeting. Results: We established three distinct treatment protocols, each with three tiers whereby higher tiers involve therapies with higher risk. One protocol addresses the management of ICP elevation when brain oxygenation is normal. A second addresses management of brain hypoxia with normal ICP. The third protocol addresses the situation when both intracranial hypertension and brain hypoxia are present. The panel considered issues pertaining to blood transfusion and ventilator management when designing the different algorithms. Conclusions: These protocols are intended to assist clinicians in the management of patients with both ICP and brain oxygen monitors but they do not reflect either a standard-of-care or a substitute for thoughtful individualized management. These protocols should be used in conjunction with recommendations for basic care, management of critical neuroworsening and weaning treatment recently published in conjunction with the Seattle International Brain Injury Consensus Conference.",
keywords = "Algorithm, Brain injury, Brain oxygen, Consensus, Head trauma, Intracranial pressure, PO, Protocol, SIBICC, Seattle, Tiers",
author = "Randall Chesnut and Sergio Aguilera and Andras Buki and Eileen Bulger and Giuseppe Citerio and Cooper, {D. Jamie} and Arrastia, {Ramon Diaz} and Michael Diringer and Anthony Figaji and Guoyi Gao and Romer Geocadin and Jamshid Ghajar and Odette Harris and Alan Hoffer and Peter Hutchinson and Mathew Joseph and Ryan Kitagawa and Geoffrey Manley and Stephan Mayer and Menon, {David K.} and Geert Meyfroidt and Michael, {Daniel B.} and Mauro Oddo and David Okonkwo and Mayur Patel and Claudia Robertson and Rosenfeld, {Jeffrey V.} and Rubiano, {Andres M.} and Juan Sahuquillo and Franco Servadei and Lori Shutter and Deborah Stein and Nino Stocchetti and Taccone, {Fabio Silvio} and Shelly Timmons and Eve Tsai and Ullman, {Jamie S.} and Paul Vespa and Walter Videtta and Wright, {David W.} and Christopher Zammit and Hawryluk, {Gregory W.J.}",
note = "Funding Information: We thank our moderators Kevin Dunne and Theodore Michalke, Jone Howard for our audience response system, Kelley Chaddock for extensive administrative support, and Peter Hendrickson, PhD, for managing our web-based surveys. We acknowledge the influence that the BOOST-3 Clinical Standardization Committee (Lori Shutter, Lisa Merck, Ramon Diaz-Arrastia, Rocco Armonda, Francis Bernard, Randall Chesnut, Anita Fetzick, Claude Hemphill, Luke James, Ryan Kitagawa, Carol Moore, David Okonkwo, Ava Puccio, Claudia Robertson, Uzma Samadani, Danielle Sandsmark, Robert Silbergleit) had on the generation of these protocols. We thank our financial supporters who include Adler/Geirsch Attorney at Law, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Neurotrauma and Critical Care, Bard, the Brain Trauma Foundation, DePuy, Hemedex, Integra, the Neurointensive Care Section of the European Society of Intensive Care Medicine, the Neurosurgery Society of Australasia, Medtronic, Moberg Research, Natus, Neuroptics, Raumedic, Sophysa, Stryker, and Zoll. PJH is supported by the NIHR (Research Professorship, Cambridge BRC and Global Health Research Group on Neurotrauma), and DKM is an Emeritus Senior Investigator of the National Institute of Health Research (UK). Funding Information: We thank our moderators Kevin Dunne and Theodore Michalke, Jone Howard for our audience response system, Kelley Chaddock for extensive administrative support, and Peter Hendrickson, PhD, for managing our web-based surveys. We acknowledge the influence that the BOOST-3 Clinical Standardization Committee (Lori Shutter, Lisa Merck, Ramon Diaz-Arrastia, Rocco Armonda, Francis Bernard, Randall Chesnut, Anita Fetzick, Claude Hemphill, Luke James, Ryan Kitagawa, Carol Moore, David Okonkwo, Ava Puccio, Claudia Robertson, Uzma Samadani, Danielle Sandsmark, Robert Silbergleit) had on the generation of these protocols. We thank our financial supporters who include Adler/Geirsch Attorney at Law, the American Association of Neurological Surgeons/Congress of Neurological Surgeons Section on Neurotrauma and Critical Care, Bard, the Brain Trauma Foundation, DePuy, Hemedex, Integra, the Neurointensive Care Section of the European Society of Intensive Care Medicine, the Neurosurgery Society of Australasia, Medtronic, Moberg Research, Natus, Neuroptics, Raumedic, Sophysa, Stryker, and Zoll. PJH is supported by the NIHR (Research Professorship, Cambridge BRC and Global Health Research Group on Neurotrauma), and DKM is an Emeritus Senior Investigator of the National Institute of Health Research (UK). Publisher Copyright: {\textcopyright} 2020, The Author(s).",
year = "2020",
month = may,
day = "1",
doi = "10.1007/s00134-019-05900-x",
language = "English (US)",
volume = "46",
pages = "919--929",
journal = "Intensive Care Medicine",
issn = "0342-4642",
publisher = "Springer Verlag",
number = "5",
}