Management of comatose head-injured patients: are we getting any better?
✍ Scribed by I. A. Wilkins; D. K Menon; B. F. Matta
- Publisher
- John Wiley and Sons
- Year
- 2001
- Tongue
- English
- Weight
- 260 KB
- Volume
- 56
- Category
- Article
- ISSN
- 0003-2409
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✦ Synopsis
This re-survey of neurosurgical centres was conducted to determine whether the publication of management guidelines has resulted in changes in the intensive care management of severely head-injured patients (defined as Glasgow Coma Score < 9) in the UK and Ireland. Results were compared with data collected from a similar survey conducted 2 years earlier. Almost 75% of centres monitor intracranial pressure in the majority of patients and 80% now set a target cerebral perfusion pressure of > 70 mmHg. The use of prolonged hyperventilation (> 12 h) is declining and the target PaCO2 is now most commonly > 4 kPa. More centres maintain core temperature < 36.5 degrees C. Although wide variations in the management of severely head-injured patients still exist, we found evidence of practice changing to comply with published guidelines.