Update in the treatment of traumatic brain injury

被引：5

作者：

Bell S.E. ^{[1
]}

Hlatky R. ^{[1
]}

机构：

[1] Department of Neurosurgery, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229

来源：

Current Treatment Options in Neurology | 2006年 / 8卷 / 2期

关键词：

Traumatic Brain Injury; Sufentanil; Cerebral Perfusion Pressure; Hypertonic Saline; Mean Arterial Blood Pressure;

D O I：

10.1007/s11940-006-0007-9

中图分类号：

学科分类号：

摘要：

This review focuses on recent advances in the treatment of traumatic brain injury (TBI) during 2004 and 2005. Injured brain is a very heterogeneous structure, significantly evolving over time. Implementation of multimodal neuromonitoring will certainly provide more insights into pathophysiology of TBI. More studies are needed to determine how to best incorporate these new parameters into effective management protocols. Based on current literature, corticosteroids should not be indicated for the treatment of TBI. Avoidance or immediate treatment of secondary insults remains a mainstream of clinical care for patients with TBI. It seems that the therapy should focus on control of intracranial hypertension, and values of cerebral perfusion pressure around 60 mm Hg appear to correlate with favorable outcome in most patients. Hypertonic saline may become a preferred osmotherapeutic agent in severely head-injured patients, especially those with refractory intracranial hypertension. Benefit and indications for performing a decompressive craniectomy remain to be determined. Overall, individualized treatment respecting actual status of a patient's intra- and extracranial homeostasis should be the key principle of our current therapeutic approach toward severely head-injured patients. Copyright © 2006 by Current Science Inc.

引用

页码：167 / 175

页数：8

共 29 条

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