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RESEARCH PRODUCT

Intensive Care Management of Head-Injured Patient

subject

description

Traumatic brain injury (TBI) plays an important role for the prognosis of multiple injured patients. Severely injured patients require intensive care treatment to support organ function and to maintain normal brain physiology. Optimal treatment is a cornerstone for good outcome. Therefore, in addition to general principles and concepts of modern intensive care medicine, special brain-specific aspects need to be addressed in these patients. Essential aspects of physiological regulation of cerebral perfusion and intracranial pressure as well as recent publications are reviewed as basis for current trends in the management of TBI patients. Focusing on single parameters such as intracranial pressure (ICP) or cerebral perfusion pressure failed to increase the number of patients with good long-term functional outcome. Recent data support the use of a multimodal approach monitoring intracranial pressure in combination with cerebral oxygenation to limit negative effects of ICP treatment. The article presents current concepts to prevent and treat rise in ICP and cerebral malperfusion.