Neurotrauma. Issue 6 (20th December 2022)

• Record Type: Journal Article
• Authors: Niziolek, Grace; Sandsmark, Danielle K.; Pascual, Jose L.
• Is Part Of: Current opinion in critical care. Volume 28:Issue 6(2022)
• Page Start: 715
• Page End: 724
• Publication Date: 2022-12-20
• Subjects: beta-blocker -- biomarkers -- brain tissue oxygenation -- traumatic brain injury -- venous thromboembolism prophylaxis; Critical care medicine -- Periodicals; 616.028
• DOI: 10.1097/MCC.0000000000001005
• Languages: English
• ISSNs: 1070-5295

Abstract

Abstract : Purpose of review: This review will highlight the latest research relevant to the clinical care of traumatic brain injury (TBI) patients over the last 2 years while underscoring the implications of these advances in the understanding of diagnosis, treatment, and prognosis of TBI. Recent findings: Brain tissue oxygenation monitoring can identify hypoperfusion as an adjunct to intracerebral pressure monitoring. Multiple biomarker assays are now available to help clinicians screen for mild TBI and biomarker elevations correlate with the size of intracranial injury. Beta-blocker exposure following TBI has demonstrated a survival benefit in those with TBI though the mechanism for this remains unknown. The optimal timing for venous thromboembolism prophylaxis for TBI patients is still uncertain. Summary: The current characterization of TBI as mild, moderate, or severe fails to capture the complexity of the disease process and helps little with prognostication. Molecular biomarkers and invasive monitoring devices including brain tissue oxygenation and measures of cerebral autoregulation are being utilized more commonly and can help guide therapy. Extracranial complications following TBI are common and include infection, respiratory failure, coagulopathy, hypercoagulability, and paroxysmal sympathetic hyperactivity.