Author:
Sahjpaul Ramesh,Girotti Murray
Abstract
ABSTRACT:Objective:The purpose of this study was to obtain information from Canadian neurosurgeons regarding their opinions on, and utilization of, intracranial pressure (ICP) monitoring for severe traumatic brain injury (TBI).Methods:A brief survey was sent to practicing Canadian neurosurgeons questioning them about their utilization of, and confidence in, intracranial pressure monitoring in the management of patients with severe TBI.Results:One hundred and ninety-six surveys were mailed. There were 103 responses for a response rate of 52.6%. The vast majority of responding neurosurgeons (98.1%) utilized ICP monitoring in the management of patients with severe TBI, with most (63.4%) using it in more than 75% of their patients, 14.9% using it in 50-75% of patients, 14.9% in 25-50% of patients, and 6.9% using it in less than 25% of patients. The level of confidence that routine monitoring improves outcome from severe TBI ranged from 23.3% having a low level of confidence, 56.3% having an intermediate level of confidence, to 20.4% having a high level of confidence. Most respondents (78.6%) felt that some form of prospective trial evaluating the role of ICP monitoring in improving outcome from severe TBI was warranted; 17.4% felt such a trial was not warranted and 3.9% were uncertain.Conclusions:While ICP monitoring has gained almost universal acceptance among responding Canadian neurosurgeons, their level of confidence that routine monitoring improves outcome from severe TBI was quite variable, with only 20.4% of respondents having a high level of confidence. Over 75% of respondents felt that some form of prospective trial evaluating the utility of ICP monitoring is warranted. This information is being used in consideration of a prospective trial addressing this issue.
Publisher
Cambridge University Press (CUP)
Subject
Neurology (clinical),Neurology,General Medicine
Reference34 articles.
1. Management of Severe Traumatic Brain Injury in 1997: The Impact of the Guidelines for the Management of Severe Head Injuries. AANS and CNS Joint Section on Neurotrauma and Critical Care;Marion;Summer/Fall,1997
2. Changes in cerebral blood flow and metabolism related to the presence of subdural hematoma;Salvant;Neurosurgery,1993
3. Survey of intensive care of severely head injured patients in the United Kingdom
4. Relationship of early cerebral blood flow and metabolism to outcome in acute head injury
5. Treating elevated intracranial pressure