Update on traumatic brain injury in the ICU.

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY
Current Opinion in Anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-02-12 DOI:10.1097/ACO.0000000000001468
Rosalinde E R Slot, Raimund Helbok, Mathieu van der Jagt
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引用次数: 0

Abstract

Purpose of review: This review aims to summarize recent developments for the management of severe traumatic brain injury (TBI) in the ICU. Recent advancements in TBI ICU management emphasize a progression toward more multimodal approaches and mitigating secondary brain injury by increased focus on careful systemic management.

Recent findings: Invasive monitoring techniques such as continuous intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO 2 ) monitoring are considered standard of care or may become crucial, respectively, for managing severe TBI. Technological advances in noninvasive techniques (e.g. quantitative pupillometry) are likely to advance our diagnostic and prognostic ability. Blood biomarkers, including glial fibrillary acidic protein, neurofilament light chain, and ubiquitin carboxy-terminal hydrolase L1, provide minimally invasive ways to better assess injury severity and predict outcomes. These advancements support personalized care, which will likely influence clinical management strategies in the future.

Summary: ICP monitoring remains a key component of severe TBI management in ICU. Emerging evidence is slowly changing and improving intensive care and patient outcomes and include both brain-targeted therapies and careful systemic intensive care management.

重症监护室创伤性脑损伤最新情况。
综述目的:本综述旨在总结重症监护病房重型创伤性脑损伤(TBI)治疗的最新进展。TBI ICU管理的最新进展强调了向多模式方法的发展,并通过更加关注谨慎的系统管理来减轻继发性脑损伤。最近的发现:侵入性监测技术,如持续颅内压(ICP)和脑组织氧压(PbtO2)监测,被认为是标准护理或可能成为治疗严重TBI的关键。无创技术(如定量瞳孔测量)的技术进步可能会提高我们的诊断和预后能力。血液生物标志物,包括胶质纤维酸性蛋白、神经丝轻链和泛素羧基末端水解酶L1,提供了微创的方法来更好地评估损伤的严重程度和预测结果。这些进步支持个性化护理,这可能会影响未来的临床管理策略。总结:颅内压监测仍然是ICU重症颅脑损伤管理的关键组成部分。新出现的证据正在慢慢改变和改善重症监护和患者预后,包括脑靶向治疗和精心的系统重症监护管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
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