@article{4ef0f4d201e34aa6a96d82217add86c6,
title = "Twenty-Five Years of Intracranial Pressure Monitoring After Severe Traumatic Brain Injury: A Retrospective, Single-Center Analysis",
abstract = "BACKGROUND Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period has also seen changes in management strategies with the implementation of protocolled specialist neurocritical care, expansion of neuromonitoring techniques, and adjustments of clinical treatment targets.OBJECTIVE To describe the changes in intracranial monitoring variables over the past 25 yr.METHODS Data from 1146 TBI patients requiring ICP monitoring were analyzed. Monitored variables included ICP, cerebral perfusion pressure (CPP), and the cerebral pressure reactivity index (PRx). Data were stratified into 5-yr epochs spanning the 25 yr from 1992 to 2017.RESULTS CPP increased sharply with specialist neurocritical care management (PCONCLUSION We demonstrate the evolving trends in neurophysiological monitoring over the past 25 yr from a single, academic neurocritical care unit. ICP and CPP were responsive to the introduction of an ICP/CPP protocol while PRx has remained unchanged.",
keywords = "Traumatic brain injury, Intracranial pressure, Cerebral hemodynamics, Autoregulation, Outcome, CEREBRAL PERFUSION-PRESSURE, CEREBROVASCULAR REACTIVITY, DECOMPRESSIVE CRANIECTOMY, HEAD-INJURY, MANAGEMENT, AUTOREGULATION, BEDSIDE, CARE, THRESHOLDS, TRIAL",
author = "Joseph Donnelly and Marek Czosnyka and Hadie Adams and Danilo Cardim and Kolias, {Angelos G.} and Zeiler, {Frederick A.} and Andrea Lavinio and Marcel Aries and Chiara Robba and Peter Smielewski and Hutchinson, {Peter J. A.} and Menon, {David K.} and Pickard, {John D.} and Budohoski, {Karol P.}",
note = "Funding Information: These studies were supported by National Institute for Healthcare Research (NIHR, UK) through the Acute Brain Injury and Repair theme of the Cambridge NIHR Biomedical Research Centre, an NIHR Senior Investigator Award to Dr Menon, and an NIHR Research Professorship to Dr Hutchinson. Dr Donnelly is supported by a Woolf Fisher Scholarship (New Zealand). Dr Zeiler has received salary support for dedicated research time from the Cambridge Commonwealth Trust Scholarship, the University of Manitoba Clinician Investigator Program, and the Royal College of Surgeons of Canada—Harry S. Morton Travelling Fellowship in Surgery, during which this project was completed. Dr Hutchinson and Dr Menon were also supported by a European Union Framework Program 7 grant (CENTER-TBI; Grant Agreement No. 602150). Dr Zeiler and Dr Cardim have received PhD funding from the Cambridge Commonwealth Trust. Dr Kolias, Dr Hutchinson, Dr Menon, and Dr Budohoski declare funding from the NIHR Global Health Research Group on Neurotrauma, which was commissioned by the NIHR using Official Development Assistance (ODA) funding (project 16/137/105). The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, National Institute for Health Research or the Department of Health. The authors have the following potential conflicts of interest: Dr Czosnyka receives part of licensing fees for ICM+, owned and distributed by Cambridge Enterprise Ltd; paid lectures for Integra Lifescience Speakers{\textquoteright} Bureau; and is partially supported by National Institute of Health Research Medtech and In vitro diagnostics co-operatives in Cambridge. Dr Smielewski receives part of the licensing fees for the software ICM (Cambridge Enterprise Ltd, Cambridge UK), used in this project for data collection and data preprocessing. The other authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article. Dr Menon has had consultancy, research collaboration, or trial data monitoring interactions with Solvay Ltd; GlaxoSmithKline Ltd; Brainscope Ltd; Ornim Medical; Shire Medical, and Neurovive Ltd; Calico Inc; Pfizer Ltd; Pressura Ltd; Glide Pharma Ltd; and NeuroPro Ltd. Publisher Copyright: Copyright {\textcopyright} 2018 by the Congress of Neurological Surgeons.",
year = "2019",
month = jul,
doi = "10.1093/neuros/nyy468",
language = "English",
volume = "85",
pages = "E75--E82",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Oxford University Press",
number = "1",
}