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16 results

  • Chapter 14 - Therapeutic Options in Neurocritical Care

  • Edited by Peter C. Whitfield, Jessie Welbourne, Elfyn Thomas, Fiona Summers, Maggie Whyte, Peter J. Hutchinson
  • Book:
    Traumatic Brain Injury
    Published online:
    28 April 2020
    Print publication:
    07 May 2020, pp 164-185

  • Summary

    It has long been recognised that a neurological injury can elicit profound systemic complications, from Harvey Cushing who in 1903 described strategies to limit fatal haemodynamic dysfunction during surgical CNS surgery to reports of pulmonary oedema post-seizures in 1908.1

    Studies of patients admitted to intensive care with traumatic brain injury (TBI) showed that up to 89% developed non-neurological organ dysfunction, worsening their outcome.2,3 Most commonly patients develop sepsis, respiratory or cardiovascular complications with rates of 75%, 41% and 44% respectively in one cohort.3 Renal and hepatic system involvement is much less common.4 The presence of hypotension, severe respiratory failure or sepsis has been shown to be independent predictors of death and mortality rates rise from 31%–40% for single organ failure to 47%–91% with two organ system failures and up to 100% in cases with three or more organ system failures.

Traumatic Brain Injury
  • A Multidisciplinary Approach
  • 2nd edition
  • Edited by Peter C. Whitfield, Jessie Welbourne, Elfyn Thomas, Fiona Summers, Maggie Whyte, Peter J. Hutchinson
  • Published online:
    28 April 2020
    Print publication:
    07 May 2020
  • Advocating a pragmatic and multidisciplinary approach to the management of patients with brain injuries, Traumatic Brain Injury provides a detailed description of care along the whole-patient pathway. Delivering an evidence-based update on the optimal care of both adult and paediatric patients who have sustained injuries ranging from mild to severe, information from on-going multi-centre studies in neurotrauma is included. The basic scientific principles of neuropathology, head injury research and scoring systems are presented before detailed sections on emergency department care, patient transfer, intensive care and longer-term care. Rehabilitation is reviewed in detail with chapters discussing the aims and roles of physiotherapy, occupational therapy and neuropsychology amongst others. Discussing medico-legal issues in detail, the effect of injury on the individual and their family are also examined. Emphasising a holistic approach to caring for patients with brain injuries, this is an essential guide for all involved.

Head Injury
  • A Multidisciplinary Approach
  • Edited by Peter C. Whitfield, Elfyn O. Thomas, Fiona Summers, Maggie Whyte, Peter J. Hutchinson
  • Published online:
    25 January 2010
    Print publication:
    09 April 2009
  • The management of patients with head injury requires a pragmatic, multi-professional approach, as exemplified in this book. The content includes chapters on epidemiology, experimental models, pathology, clinical examination, neuroimaging and trauma scoring systems. A large section of the text then deals with the management of the head-injured patient along the whole patient pathway, addressing issues such as emergency department care, transfer of the patient, intensive care and surgical aspects. Rehabilitation is reviewed in detail with chapters that discuss the aims and roles of physiotherapy, occupational therapy, speech and language therapy and neuropsychology. Finally, medico-legal issues are evaluated. The practical approach to management is emphasized throughout. This book will be of interest to all doctors looking after patients with head injury: emergency physicians, neurosurgeons, anaesthetists, intensivists, and members of the rehabilitation team. Allied specialists such as nurses, physiotherapists, speech and language therapists, occupational therapists, and neuropsychologists will also find this book useful.