Championing individualised neurointensive care
- Neurological examination
- Imaging
- Monitoring
The RCTs of therapies in Neuro ICU have shown no effect on pt prognosis
A Trial of Intracranial-Pressure Monitoring in Traumatic Brain Injury
So what do you do??
Evidence for Health Decision Making — Beyond Randomized, Controlled Trials
Severe traumatic brain injury: targeted management in the intensive care unit.
But it may be that we are not finding the solution/therapy due to the heterogeneity of TBI
A response to the Chestnut trial –
There is therefore an unsurprising degree of variation in how TBIs are managed.
- Outcome was more favourable in pts treated in aggressive centres
Multi Modal Monitoring (MMM)
Multimodal monitoring approach improves ability to detect hypoperfusion in the injured brain
New paradigm – quantitative brain function monitoring
Electroencephalography as a Prognostic Tool after Cardiac Arrest.
Summary