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Journal ArticleDOI

Association of Ventilation during Initial Trauma Resuscitation for Traumatic Brain Injury and Post-Traumatic Outcomes: A Systematic Review

TLDR
In this paper, a literature search of PubMed, CINAHL, and SCOPUS identified studies from 2009 through 2019 addressing the effects of ventilation during the initial post-trauma resuscitation on patient outcomes.
Abstract
Objectives: In the absence of evidence of acute cerebral herniation, normal ventilation is recommended for patients with traumatic brain injury (TBI). Despite this recommendation, ventilation strategies vary during the initial management of patients with TBI and may impact outcome. The goal of this systematic review was to define the best evidence-based practice of ventilation management during the initial resuscitation period. Methods: A literature search of PubMed, CINAHL, and SCOPUS identified studies from 2009 through 2019 addressing the effects of ventilation during the initial post-trauma resuscitation on patient outcomes. Results: The initial search yielded 899 articles, from which 13 were relevant and selected for full-text review. Six of the 13 articles met the inclusion criteria, all of which reported on patients with TBI. Either end-tidal carbon dioxide (ETCO2) or partial pressure carbon dioxide (PCO2) were the independent variables associated with mortality. Decreased rates of mortality were reported in patients with normal PCO2 or ETCO2. Conclusions: Normoventilation, as measured by ETCO2 or PCO2, is associated with decreased mortality in patients with TBI. Preventing hyperventilation or hypoventilation in patients with TBI during the early resuscitation phase could improve outcome after TBI.

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Citations
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Journal ArticleDOI

Management of traumatic brain injury: a narrative review of current evidence

TL;DR: In this paper , the authors provide clinicians with a summary of recent studies of direct relevance to the management of traumatic brain injury in order to promote best clinical practice, including the use of tranexamic acid.
References
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Journal ArticleDOI

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

TL;DR: A reporting guideline is described, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015), which consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review.
Journal ArticleDOI

Rayyan-a web and mobile app for systematic reviews.

TL;DR: The strongest features of the app, identified and reported in user feedback, were its ability to help in screening and collaboration as well as the time savings it affords to users.
Journal ArticleDOI

Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition

TL;DR: The scope and purpose of this work is to synthesize the available evidence and to translate it into recommendations, so that these recommendations be used by others to develop treatment protocols, which necessarily need to incorporate consensus and clinical judgment in areas where current evidence is lacking or insufficient.
Journal ArticleDOI

The role of secondary brain injury in determining outcome from severe head injury.

TL;DR: The increased morbidity and mortality related to severe trauma to an extracranial organ system appeared primarily attributable to associated hypotension, and improvements in trauma care delivery over the past decade have not markedly altered the adverse influence of hypotension.
Journal ArticleDOI

Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial

TL;DR: It is concluded that prophylactic hyperventilation is deleterious in head-injured patients with motor scores of 4-5 and that the course of ICP was most stable in the HV + THAM group, although mean ICP could be kept well below 25 mm Hg in all three groups.
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