Management of comatose head‐injured patients: are we getting any better?
- 1 April 2001
- journal article
- research article
- Published by Wiley in Anaesthesia
- Vol. 56 (4) , 350-369
- https://doi.org/10.1046/j.1365-2044.2001.01708.x
Abstract
This re‐survey of neurosurgical centres was conducted to determine whether the publication of management guidelines has resulted in changes in the intensive care management of severely head‐injured patients (defined as Glasgow Coma Score < 9) in the UK and Ireland. Results were compared with data collected from a similar survey conducted 2 years earlier. Almost 75% of centres monitor intracranial pressure in the majority of patients and 80% now set a target cerebral perfusion pressure of > 70 mmHg. The use of prolonged hyperventilation (> 12 h) is declining and the target Paco2 is now most commonly > 4 kPa. More centres maintain core temperature < 36.5 °C. Although wide variations in the management of severely head‐injured patients still exist, we found evidence of practice changing to comply with published guidelines.Keywords
This publication has 8 references indexed in Scilit:
- Guidelines for the Management of Severe Head InjuryThe Journal of Trauma: Injury, Infection, and Critical Care, 1997
- EBIC-Guidelines for management of severe head injury in adultsActa Neurochirurgica, 1997
- Treatment of Traumatic Brain Injury with Moderate HypothermiaNew England Journal of Medicine, 1997
- Letters to the EditorThe Journal of Trauma: Injury, Infection, and Critical Care, 1997
- Severe head injury in the United Kingdom and IrelandCritical Care Medicine, 1996
- Survey of intensive care of severely head injured patients in the United KingdomBMJ, 1996
- Cerebral perfusion pressure: management protocol and clinical resultsJournal of Neurosurgery, 1995
- Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trialJournal of Neurosurgery, 1991