How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

10,582 results for

Management of Severe Head Injury

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

10561. Therapeutic effect of mild hypothermia on severe traumatic head injury. (PubMed)

Therapeutic effect of mild hypothermia on severe traumatic head injury. To investigate the therapeutic effect of mild hypothermia on severe traumatic brain injury.Eighty-six in-patients with severe traumatic brain injury treated ordinarily were consecutively randomized into two groups: a hypothermia group (n=43) and a normothermia group (the control group, n=43). In the hypothermia group, the core temperature (i.e., nasopharyngeal or brain temperature) of the patient was reduced (...) and renal malfunction, were managed without severe sequelae.Mild hypothermia is a safe and effective therapeutic method, which can lower the extradural pressure, increase the serum superoxide dismutase and improve the neurological outcomes without severe complications in the patients with severe traumatic brain injury.

2005 Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association Controlled trial quality: uncertain

10562. The role of hypothermia in the management of severe brain injury: a meta-analysis. (PubMed)

is not beneficial in the management of severe head injury. However, because hypothermia continues to be used to treat these injuries, additional studies are justified and urgently needed. (...) The role of hypothermia in the management of severe brain injury: a meta-analysis. Hypothermia is utilized in the management of severe traumatic brain injury despite the lack of unequivocal evidence supporting its use. Because of its widespread use, the effects of hypothermia are a concern.To determine the effectiveness of hypothermia in the management of severe brain injury.Two investigators working independently abstracted data in a blinded fashion from studies identified using multiple

2002 Archives of neurology

10563. Interventions and service need following mild and moderate head injury: the Oxford Head Injury Service. (PubMed)

Interventions and service need following mild and moderate head injury: the Oxford Head Injury Service. To describe the interventions given by the Oxford Head Injury Service (OXHIS) to patients seen after head injury, predominantly mild or moderate, over the first six months after their injuries.Descriptive data of the amounts of early intervention provided by OXHIS in relation to severity of head injury and the amount of service need identified at six month follow-up.OXHIS aimed to register (...) all patients aged 16-65 with a head injury of any severity, resident in Oxfordshire. It contacted and provided interventions for a random half of those registered at 7-10 days post-injury as part of a randomized controlled trial to investigate the effectiveness of early follow-up. At six months post-injury, independent assessment of all those registered was undertaken to evaluate outcome and identify continuing service needs.The data come from the 579 patients (of the 1156 registered), randomized

1997 Clinical rehabilitation Controlled trial quality: uncertain

10564. Hypothermia and hyperbaric oxygen as treatment modalities for severe head injury. (PubMed)

Hypothermia and hyperbaric oxygen as treatment modalities for severe head injury. Moderate systemic hypothermia has been shown to improve neurologic outcomes in both fluid-percussion and cortical contusion models of experimental brain injury. Based upon initial clinical work, it was concluded that at temperatures < 32 degrees C, patients with severe brain injury were at increased risk of ventricular arrhythmias, and that rapid rewarming immediately postinjury predisposed to intracranial (...) pressure increases. Subsequent clinical studies of moderate hypothermia (32 degrees C) for 24- to 48-hr duration with slow rewarming in human brain injury showed indications of neurologic improvement and a low incidence of hypothermia-related complications. Based upon the strengths of both laboratory and clinical data, a multicenter (nine centers), randomized, prospective trial testing moderate systemic hypothermia in patients with severe brain injury has been organized. This trial, funded by National

1995 New horizons (Baltimore, Md.)

10565. Prevention of acute gastrointestinal complications after severe head injury: a controlled trial of cimetidine prophylaxis. (PubMed)

Prevention of acute gastrointestinal complications after severe head injury: a controlled trial of cimetidine prophylaxis. Cimetidine prophylaxis significantly reduced the risk of gastrointestinal bleeding after severe head injury in this prospective, double-blind clinical trial. Cimetidine effectively reduced both the volume and the acidity of gastric secretions after brain injury without producing adverse side effects. The most common endoscopic finding was superficial, erosive, mucosal (...) lesions in the proximal stomach. Cimetidine prophylaxis was not shown to reduce the incidence of these lesions in this study but did diminish their severity and the likelihood that they would complicate the management of these patients.

1980 American journal of surgery

10566. Outcome after severe head injury treated by an integrated trauma system. (PubMed)

Outcome after severe head injury treated by an integrated trauma system. To describe outcome after treatment of severe head injury within an integrated trauma system.A retrospective analysis of all patients with severe head injury admitted to the Royal London Hospital by the Helicopter Emergency Medical Service (HEMS) between 1991 and 1994. Type of injury was defined on initial computed tomography of the head and outcomes assessed 12 months after injury using the Glasgow outcome score.6.5 (...) % of HEMS patients had long term severe disability (severe disability or persistent vegetative state on the outcome score); 34.5% made a good recovery.The concern that a large number of severely disabled long term survivors might result as a consequence of this system of trauma management is not confirmed. The case mix of severity of extracranial injuries in these patients makes comparison with other published series difficult, but these data fit the hypothesis that pre-hospital correction of hypoxia

Full Text available with Trip Pro

1999 Journal of accident & emergency medicine

10567. Effect of THAM upon outcome in severe head injury: a randomized prospective clinical trial. (PubMed)

Effect of THAM upon outcome in severe head injury: a randomized prospective clinical trial. Although mortality and morbidity rates from head injury have been reduced substantially by improved prehospital interventions, intensive care, and aggressive management of intracranial pressure (ICP), successful treatment of the primary brain injury has been elusive. In experimental models, tromethamine (THAM) has been effective in treating head injury; this drug acts by entering the cerebrospinal fluid (...) compartment, reducing cerebral acidosis and ICP, and reversing the adverse effects of prophylactic hyperventilation on early recovery. In this randomized prospective clinical trial, THAM was studied to determine if it had beneficial effects in the early management of severe head injuries and if the adverse effects of hyperventilation could be prevented. A total of 149 patients with severe head injury (Glasgow Coma Scale scores of < or = 8) were randomly assigned to either a control or a THAM group. Both

Full Text available with Trip Pro

1993 Journal of neurosurgery Controlled trial quality: uncertain

10568. Improving the outcome of severe head injury with the oxygen radical scavenger polyethylene glycol-conjugated superoxide dismutase: a phase II trial. (PubMed)

Improving the outcome of severe head injury with the oxygen radical scavenger polyethylene glycol-conjugated superoxide dismutase: a phase II trial. Formation of the oxygen radical superoxide anion is one of the final events of several metabolic pathways in the cascade that leads to delayed neuronal death after traumatic or ischemic brain injury. In the laboratory, scavenging of the superoxide anion with native superoxide dismutase (SOD) or polyethylene glycol (PEG)-conjugated SOD (PEG-SOD) has (...) been shown to be beneficial in several types of traumatic and ischemic injury. Accordingly, PEG-SOD was utilized in a randomized controlled Phase II trial to evaluate its safety and efficacy in severely head-injured patients with a Glasgow Coma Scale score of 8 or less. At two institutions, 104 patients were randomly assigned to receive either placebo or PEG-SOD (2000, 5000, or 10,000 U/kg) intravenously as a bolus, an average of 4 hours after injury. Prognostic factors were evenly distributed

Full Text available with Trip Pro

1993 Journal of neurosurgery Controlled trial quality: uncertain

10569. Prevention of secondary ischemic insults after severe head injury. (PubMed)

Prevention of secondary ischemic insults after severe head injury. The purpose of this study was to compare the effects of two acute-care management strategies on the frequency of jugular venous desaturation and refractory intracranial hypertension and on long-term neurologic outcome in patients with severe head injury.Randomized clinical trial.Level I trauma hospital.One hundred eighty-nine adults admitted in coma because of severe head injury.Patients were assigned to either cerebral blood (...) the injury that occurred in the ICP-targeted group. The beneficial effects of the CBF-targeted protocol may have been offset by a five-fold increase in the frequency of adult respiratory distress syndrome.Secondary ischemic insults caused by systemic factors after severe head injury can be prevented with a targeted management protocol. However, potential adverse effects of this management strategy may offset these beneficial effects.

1999 Critical care medicine Controlled trial quality: uncertain

10570. Intracranial hypertension and cerebral perfusion pressure: influence on neurological deterioration and outcome in severe head injury. The Executive Committee of the International Selfotel Trial. (PubMed)

Intracranial hypertension and cerebral perfusion pressure: influence on neurological deterioration and outcome in severe head injury. The Executive Committee of the International Selfotel Trial. Recently, a renewed emphasis has been placed on managing severe head injury by elevating cerebral perfusion pressure (CPP), which is defined as the mean arterial pressure minus the intracranial pressure (ICP). Some authors have suggested that CPP is more important in influencing outcome than (...) > or = 20 mm Hg) either initially or during neurological deterioration. There was no correlation with the CPP as long as the CPP was greater than 60 mm Hg.Treatment protocols for the management of severe head injury should emphasize the immediate reduction of raised ICP to less than 20 mm Hg if possible. A CPP greater than 60 mm Hg appears to have little influence on the outcome of patients with severe head injury.

Full Text available with Trip Pro

2000 Journal of neurosurgery Controlled trial quality: uncertain

10571. Adult respiratory distress syndrome: a complication of induced hypertension after severe head injury. (PubMed)

flow (CBF) and increase intracranial pressure (ICP). In a recent randomized trial of two head-injury management strategies (ICP-targeted and CBF-targeted), a fivefold increase in the incidence of ARDS was observed in the CBF-targeted group.Injury severity, physiological data, and treatment data in 18 patients in whom ARDS had developed were compared with the remaining 171 patients in the randomized trial in whom it had not developed. Logistic regression analysis was used to study the interaction (...) Adult respiratory distress syndrome: a complication of induced hypertension after severe head injury. The factors involved in the development of adult respiratory distress syndrome (ARDS) after severe head injury were studied. The presence of ARDS complicates the treatment of patients with severe head injury, both because hypoxia causes additional injury to the brain and because therapies that are used to protect the lungs and improve oxygenation in patients with ARDS can reduce cerebral blood

Full Text available with Trip Pro

2001 Journal of neurosurgery Controlled trial quality: uncertain

10572. Prospective survey on neurosurgical intensive care for patients with severe head injury. (PubMed)

Prospective survey on neurosurgical intensive care for patients with severe head injury. To prospectively compare the clinical outcome of intensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients.Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while (...) ), while the mortality in the same range of age was decreased in Group ICT (chi(2)=5.28, P<0.05). The mortality was reduced significantly in patients with GCS for 6-8 on admission (chi(2)=8.47, P<0.01) and in patients with the level of brain stem injured below mesencephalon (chi(2)=4.15, P<0.05). ICT would improve the outcome in patients undergoing conservative therapy only (chi(2)=13.13, P<0.01).NIC plays an important role in assessing the neurological state, guiding management, evaluating curative

2001 Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association Controlled trial quality: uncertain

10573. Reduction in mortality from severe head injury following introduction of a protocol for intensive care management. (PubMed)

Reduction in mortality from severe head injury following introduction of a protocol for intensive care management. To determine the effect of an intensive care management protocol on the intensive care unit (ICU) and hospital mortality of severely head-injured patients, we designed a longitudinal observational study of all patients admitted with a head injury between 1992 and 2000.A computerized patient database was used to identify all patients with severe head injury admitted to the ICU (...) a significant increase in the median APACHE II score (14 vs 18) of patients admitted after implementation of the protocol. The median ICU and hospital length of stay remained constant over the study period.The introduction of an evidence-based protocol to guide the ICU management of patients with severe head injury has been associated with a significant reduction in both ICU and hospital mortality.

Full Text available with Trip Pro

2004 British Journal of Anaesthesia

10574. Effects of case management after severe head injury. (PubMed)

Effects of case management after severe head injury. To examine the effects of early case management for patients with severe head injury on outcome, family function, and provision of rehabilitation services.Prospective controlled unmatched non-randomised study for up to two years after injury.Four district general hospitals and two university teaching hospitals, each with neurosurgical units, in east central, north, and north east London and its environs.126 patients aged 16-60 recruited (...) acutely and sequentially after severe head injury. All received standard rehabilitation services in each of the six hospitals and districts: case management was also provided for the 56 patients admitted to three of the hospitals.Standard measures of patients' physical and cognitive impairment; disability and handicap; and affective, behavioural, and social functioning and of relatives' affective and social functioning. Relatives' perception of burden; changes in patients' and relatives' housing

Full Text available with Trip Pro

1994 BMJ Controlled trial quality: uncertain

10575. Fluid resuscitation of patients with multiple injuries and severe closed head injury: experience with an aggressive fluid resuscitation strategy. (PubMed)

Fluid resuscitation of patients with multiple injuries and severe closed head injury: experience with an aggressive fluid resuscitation strategy. Despite increasing experimental and clinical evidence to the contrary, a dichotomy of management strategies of the patient with multiple injuries still exists, based on the presence or absence of traumatic brain injury. Many still advocate fluid restriction or small volume resuscitation if traumatic brain injury is present.To demonstrate results (...) of aggressive fluid resuscitation in a prospective case series of patients with multiple injuries and with severe head injury.Thirty-four patients with Glasgow Coma Scale score < or = 8 and Injury Severity Score > or = 16 were enrolled into the study over a period of 18 months. Fluid resuscitation was guided in part by cerebral perfusion pressures (mean cerebral perfusion pressures > 80) as well as by hemodynamic monitoring and evidence of end organ perfusion. Overall fluid intake, intensive care unit fluid

2000 Journal of Trauma Controlled trial quality: uncertain

10576. Management and outcome of severe head injury in the Trent region 1985-90. (PubMed)

Management and outcome of severe head injury in the Trent region 1985-90. 8333780 1993 08 16 2018 11 13 1468-2044 68 6 1993 Jun Archives of disease in childhood Arch. Dis. Child. Management and outcome of severe head injury in the Trent region 1985-90. 803 Murdoch I I Bihari D D eng Comment Letter England Arch Dis Child 0372434 0003-9888 AIM IM Arch Dis Child. 1992 Dec;67(12):1430-5 1489220 Child Craniocerebral Trauma therapy Humans Hypothermia, Induced adverse effects Treatment Outcome 1993 6

Full Text available with Trip Pro

1993 Archives of Disease in Childhood

10577. Absence of evidence for the effectiveness of five interventions routinely used in the intensive care management of severe head injury: a systematic review. (PubMed)

Absence of evidence for the effectiveness of five interventions routinely used in the intensive care management of severe head injury: a systematic review. To assess the effectiveness of interventions routinely used in the intensive care management of severe head injury, specifically, the effectiveness of hyperventilation, mannitol, CSF drainage, barbiturates, and corticosteroids.Systematic review of all unconfounded randomised trials, published or unpublished, that were available by August (...) 1996.None of the interventions has been reliably shown to reduce death or disability after severe head injury. One trial of hyperventilation was identified of 77 participants. The relative risk for death was 0.73 (95% confidence interval (95% CI) 0.36-1.49), and for death or disability it was 1.14 (95% CI 0.82-1.58). One trial of mannitol was identified of 41 participants. The relative risk for death was 1.75 (95% CI 0.48-6.38), no data were available for disability. No randomised trials of CSF

Full Text available with Trip Pro

1998 Journal of neurology, neurosurgery, and psychiatry

10578. High dose glucocorticoids in the management of severe head injury. (PubMed)

High dose glucocorticoids in the management of severe head injury. Eighty-eight patients with a Glasgow coma score of 8 or less 6 hours after nonpenetrating head trauma were given either high dose methylprednisolone sodium succinate (30 mg/kg q6h X2, then 250 mg q6h X6, then tapering over 8 days), low dose methylprednisolone (1.5 mg/kg q6h X2, then 25 mg q6h X6, then tapering over 8 days), or placebo. Standard care including the removal of traumatic hematomas, assisted ventilation

1984 Neurosurgery

10579. Case management after severe head injury. (PubMed)

Case management after severe head injury. 7950585 1994 12 05 2018 11 13 0959-8138 309 6957 1994 Sep 24 BMJ (Clinical research ed.) BMJ Case management after severe head injury. 807 Murray-Leslie C F CF Kenny C C eng Letter England BMJ 8900488 0959-8138 AIM IM Craniocerebral Trauma rehabilitation Humans Managed Care Programs 1994 9 24 1994 9 24 0 1 1994 9 24 0 0 ppublish 7950585 PMC2540974 BMJ. 1994 Jan 1;308(6920):1-2 8298343

Full Text available with Trip Pro

1994 BMJ : British Medical Journal

10580. Decision analytic approach to severe head injury management. (PubMed)

Decision analytic approach to severe head injury management. Severe head injury management in the intensive care unit is extremely challenging due to the complex domain, the uncertain intervention efficacies, and the time-critical setting. We adopt a decision analytic approach to automate the management process. We document our experience in building a simplified influence diagram that involves about 3000 numerical parameters. We identify the inherent problems in structuring a model

Full Text available with Trip Pro

1999 Proceedings of the AMIA Symposium

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>