Moderate Traumatic Brain Injury in Adult Population: The Latin American Brain Injury Consortium Consensus for Definition and Categorization

被引:8
作者
Godoy, Daniel Agustin [1 ]
Rubiano, Andres M. [2 ,3 ]
Aguilera, Sergio [4 ]
Jibaja, Manuel [5 ,6 ]
Videtta, Walter [7 ]
Rovegno, Maximiliano [8 ]
Paranhos, Jorge [9 ]
Paranhos, Eduardo [10 ,11 ]
de Amorim, Robson Luis Oliveira [12 ]
da Silva, Ruy Castro Monteiro [13 ]
Paiva, Wellingson [14 ,15 ]
Flecha, Jorge [16 ,24 ]
Faleiro, Rodrigo Moreira [17 ,18 ]
Almanza, David [19 ,20 ]
Rodriguez, Eliana [20 ]
Carrizosa, Jorge [20 ,21 ]
Hawryluk, Gregory W. J. [22 ]
Rabinstein, Alejandro A. [23 ]
机构
[1] Sanatorio Pasteur, Neurointens Care Unit, Chacabuco 675, Catamarca 4700, Argentina
[2] Univ El Bosque, Bogota, Colombia
[3] MEDITECH Fdn, Cali, Colombia
[4] Herminda Martin Hosp, Dept Neurosurg, Chillan, Chile
[5] San Francisco Univ, Sch Med, Quito, Ecuador
[6] Eugenio Espejo Hosp, Intens Care Unit, Quito, Ecuador
[7] Hosp Posadas, Intens Care Unit, Buenos Aires, Argentina
[8] Pontificia Univ Catolica Chile, Dept Crit Care, Santiago, Chile
[9] Santa Casa Misericordia, Dept Neurosurg & Crit Care, Sao Joao Del Rei, MG, Brazil
[10] HEMORIO & Santa Barbara Hosp, Intens Care Unit, Rio De Janeiro, Brazil
[11] Santa Barbara Hosp, Rio De Janeiro, Brazil
[12] Univ Fed Amazonas, Getulio Vargas Univ Hosp, Manaus, AM, Brazil
[13] Miguel Couto Hosp, Dept Neurosurg, Rio De Janeiro, Brazil
[14] Univ Sao Paulo, Expt Surg Lab, Med Sch, Sao Paulo, Brazil
[15] Univ Sao Paulo, Div Neurol Surg, Med Sch, Sao Paulo, Brazil
[16] Trauma Hosp, Intens Care Unit, Asuncion, Paraguay
[17] Joao XXIII Hosp, Dept Neurosurg, Belo Horizonte, Brazil
[18] Felicio Rocho Hosp, Fac Ciencias Med MG, Belo Horizonte, Brazil
[19] Univ Hosp, Fdn Santa Fe Bogota, Crit & Intens Care Med Dept, Bogota, Colombia
[20] Univ Rosario, Sch Med & Hlth Sci, Bogota, Colombia
[21] Hosp Univ Fdn Santa Fe Bogota, Neurointens Care Unit, Bogota, Colombia
[22] Cleveland Clin Akron Gen Hosp, Neurol Inst, Akron, OH USA
[23] Mayo Clin, Neurocrit Care & Hosp Neurol Div, Rochester, MN USA
[24] Social Secur Inst Cent Hosp, Asuncion, Paraguay
关键词
Traumatic brain injury; Moderate; Potentially severe traumatic brain injury; Moderate head injury; Consensus; Categorization; Neuroworsening; Neurosurgery; Neurocritical care; GLASGOW COMA SCALE; OPTIC-NERVE SHEATH; INTENSIVE-CARE-UNIT; SEVERE HEAD-INJURY; INTRACRANIAL-PRESSURE; TRANSCRANIAL DOPPLER; NEUROLOGICAL DETERIORATION; CLINICAL-APPLICATIONS; TARGETED MANAGEMENT; MILD;
D O I
10.1227/neu.0000000000002912
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Moderate traumatic brain injury (TBI) is a diagnosis that describes diverse patients with heterogeneity of primary injuries. Defined by a Glasgow Coma Scale between 9 and 12, this category includes patients who may neurologically worsen and require increasing intensive care resources and/or emergency neurosurgery. Despite the unique characteristics of these patients, there have not been specific guidelines published before this effort to support decision-making in these patients. A Delphi consensus group from the Latin American Brain Injury Consortium was established to generate recommendations related to the definition and categorization of moderate TBI. Before an in-person meeting, a systematic review of the literature was performed identifying evidence relevant to planned topics. Blinded voting assessed support for each recommendation. A priori the threshold for consensus was set at 80% agreement. Nine PICOT questions were generated by the panel, including definition, categorization, grouping, and diagnosis of moderate TBI. Here, we report the results of our work including relevant consensus statements and discussion for each question. Moderate TBI is an entity for which there is little published evidence available supporting definition, diagnosis, and management. Recommendations based on experts' opinion were informed by available evidence and aim to refine the definition and categorization of moderate TBI. Further studies evaluating the impact of these recommendations will be required.
引用
收藏
页码:e57 / e70
页数:14
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