Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES).
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Picetti Edoardo, Catena Fausto, Abu-Zidan Fikri, Ansaloni Luca, Armonda Rocco A, Bala Miklosh, Balogh Zsolt J, Bertuccio Alessandro, Biffl Walt L, Bouzat Pierre, Buki Andras, Cerasti Davide, Chesnut Randall M, Citerio Giuseppe, Coccolini Federico, Coimbra Raul, Coniglio Carlo, Fainardi Enrico, Gupta Deepak, Gurney Jennifer M, Hawryluk Gregory W J, Helbok Raimund, Hutchinson Peter J A, Iaccarino Corrado, Kolias Angelos, Maier Ronald W, Martin Matthew J, Meyfroidt Geert, Okonkwo David O, Rasulo Frank, Rizoli Sandro, Rubiano Andres, Sahuquillo Juan, Sams Valerie G, Servadei Franco, Sharma Deepak, Shutter Lori, Stahel Philip F, Taccone Fabio S, Udy Andrew, Zoerle Tommaso, Agnoletti Vanni, Bravi Francesca, De Simone Belinda, Kluger Yoram, Martino Costanza, Moore Ernest E, Sartelli Massimo, Weber Dieter, Robba Chiara
Аннотация
METHODS: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted.
RESULTS: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided.
CONCLUSIONS: This consensus provides practical recommendations to support clinician's decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.