Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift

Traumatic brain injury (TBI) is a leading cause of disability and mortality globally, stemming from both primary mechanical injuries and subsequent secondary responses. Effective early management of moderate-to-severe TBI is essential to prevent secondary damage and improve patient outcomes. This re...

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Authors: Barea-Mendoza, Jesús Abelardo, Chico-Fernández, Mario, Ballesteros Sanz, María Ángeles, Caballo Manuel, Alejandro, Castaño-León, Ana M., Egea-Guerrero, J. J., Lagares, Alfonso, Morales-Varas, Guillermo, Pérez-Bárcena, Jon, Serviá Goixart, Luis, Llompart-Pou, Juan Antonio
Format: article
Publication Date:2024
Country:España
Institution:Universidad de Cantabria (UC)
Repository:UCrea Repositorio Abierto de la Universidad de Cantabria
Language:English
OAI Identifier:oai:repositorio.unican.es:10902/36396
Online Access:https://hdl.handle.net/10902/36396
Access Level:Open access
Keyword:Traumatic brain injury
Resuscitation
Secondary brain injury
Multimodal monitoring
Coagulopathy
Hemorrhagic shock
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spelling Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shiftBarea-Mendoza, Jesús AbelardoChico-Fernández, MarioBallesteros Sanz, María ÁngelesCaballo Manuel, AlejandroCastaño-León, Ana M.Egea-Guerrero, J. J.Lagares, AlfonsoMorales-Varas, GuillermoPérez-Bárcena, JonServiá Goixart, LuisLlompart-Pou, Juan AntonioTraumatic brain injuryResuscitationSecondary brain injuryMultimodal monitoringCoagulopathyHemorrhagic shockTraumatic brain injury (TBI) is a leading cause of disability and mortality globally, stemming from both primary mechanical injuries and subsequent secondary responses. Effective early management of moderate-to-severe TBI is essential to prevent secondary damage and improve patient outcomes. This review provides a comprehensive guide for the resuscitation and stabilization of TBI patients, combining clinical experience with current evidence-based guidelines. Key areas addressed in this study include the identification and classification of severe TBI, intubation strategies, and optimized resuscitation targets to maintain cerebral perfusion. The management of coagulopathy and special considerations for patients with concomitant hemorrhagic shock are discussed in depth, along with recommendations for neurosurgical interventions. This article further explores the role of multimodal neuromonitoring and targeted temperature management to mitigate secondary brain injury. Finally, it discusses end-of-life care in cases of devastating brain injury (DBI). This practical review integrates foundational and recent advances in TBI management to aid in reducing secondary injuries and enhancing long-term recovery, presenting a multidisciplinary approach to support acute care decisions in TBI patients.Funding: This research received no external funding.MDPIUniversidad de Cantabria20242024-01-01journal articlehttp://purl.org/coar/resource_type/c_6501NAhttp://purl.org/coar/version/c_be7fb7dd8ff6fe43info:eu-repo/semantics/articlehttps://hdl.handle.net/10902/36396Journal of Clinical Medicine, 2024, 13(23), 7325reponame:UCrea Repositorio Abierto de la Universidad de Cantabriainstname:Universidad de Cantabria (UC)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.unican.es:10902/363962026-06-02T12:39:31Z
dc.title.none.fl_str_mv Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
title Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
spellingShingle Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
Barea-Mendoza, Jesús Abelardo
Traumatic brain injury
Resuscitation
Secondary brain injury
Multimodal monitoring
Coagulopathy
Hemorrhagic shock
title_short Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
title_full Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
title_fullStr Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
title_full_unstemmed Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
title_sort Resuscitation and initial management after moderate-to-severe traumatic brain injury: questions for the on-call shift
dc.creator.none.fl_str_mv Barea-Mendoza, Jesús Abelardo
Chico-Fernández, Mario
Ballesteros Sanz, María Ángeles
Caballo Manuel, Alejandro
Castaño-León, Ana M.
Egea-Guerrero, J. J.
Lagares, Alfonso
Morales-Varas, Guillermo
Pérez-Bárcena, Jon
Serviá Goixart, Luis
Llompart-Pou, Juan Antonio
author Barea-Mendoza, Jesús Abelardo
author_facet Barea-Mendoza, Jesús Abelardo
Chico-Fernández, Mario
Ballesteros Sanz, María Ángeles
Caballo Manuel, Alejandro
Castaño-León, Ana M.
Egea-Guerrero, J. J.
Lagares, Alfonso
Morales-Varas, Guillermo
Pérez-Bárcena, Jon
Serviá Goixart, Luis
Llompart-Pou, Juan Antonio
author_role author
author2 Chico-Fernández, Mario
Ballesteros Sanz, María Ángeles
Caballo Manuel, Alejandro
Castaño-León, Ana M.
Egea-Guerrero, J. J.
Lagares, Alfonso
Morales-Varas, Guillermo
Pérez-Bárcena, Jon
Serviá Goixart, Luis
Llompart-Pou, Juan Antonio
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad de Cantabria
dc.subject.none.fl_str_mv Traumatic brain injury
Resuscitation
Secondary brain injury
Multimodal monitoring
Coagulopathy
Hemorrhagic shock
topic Traumatic brain injury
Resuscitation
Secondary brain injury
Multimodal monitoring
Coagulopathy
Hemorrhagic shock
description Traumatic brain injury (TBI) is a leading cause of disability and mortality globally, stemming from both primary mechanical injuries and subsequent secondary responses. Effective early management of moderate-to-severe TBI is essential to prevent secondary damage and improve patient outcomes. This review provides a comprehensive guide for the resuscitation and stabilization of TBI patients, combining clinical experience with current evidence-based guidelines. Key areas addressed in this study include the identification and classification of severe TBI, intubation strategies, and optimized resuscitation targets to maintain cerebral perfusion. The management of coagulopathy and special considerations for patients with concomitant hemorrhagic shock are discussed in depth, along with recommendations for neurosurgical interventions. This article further explores the role of multimodal neuromonitoring and targeted temperature management to mitigate secondary brain injury. Finally, it discusses end-of-life care in cases of devastating brain injury (DBI). This practical review integrates foundational and recent advances in TBI management to aid in reducing secondary injuries and enhancing long-term recovery, presenting a multidisciplinary approach to support acute care decisions in TBI patients.
publishDate 2024
dc.date.none.fl_str_mv 2024
2024-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
NA
http://purl.org/coar/version/c_be7fb7dd8ff6fe43
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10902/36396
url https://hdl.handle.net/10902/36396
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv Journal of Clinical Medicine, 2024, 13(23), 7325
reponame:UCrea Repositorio Abierto de la Universidad de Cantabria
instname:Universidad de Cantabria (UC)
instname_str Universidad de Cantabria (UC)
reponame_str UCrea Repositorio Abierto de la Universidad de Cantabria
collection UCrea Repositorio Abierto de la Universidad de Cantabria
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869423177223897088
score 15,81155

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