Management of severe traumatic brain injury (first 24 hours)

Thomas Geeraerts (1) , Lionel Velly (2, 3) , Lamine Abdennour (4) , Karim Asehnoune (5) , Gérard Audibert (6) , Pierre Bouzat (7) , Nicolas Bruder (2) , Romain Carrillon (8) , Vincent Cottenceau (9) , François Cotton (10) , Sonia Courtil-Teyssedre (11, 12) , Claire Dahyot-Fizelier (13, 14) , Frédéric Dailler (8) , Jean-Stéphane David (15) , Nicolas Engrand (16) , Dominique Fletcher (17) , Gilles Francony (18) , Laurent Gergelé (19) , Carole Ichai (20) , Etienne Javouhey (12) , Pierre-Etienne Leblanc (21, 22) , Thomas Lieutaud (23, 24) , Philippe Meyer (25) , Sebastien Mirek (26) , Gilles Orliaguet (25) , François Proust (27) , Hervé Quintard (20) , Catherine Ract (21, 22) , Mohamed Srairi (1) , Karim Tazarourte (28) , Bernard Vigué (21) , Jean-François Payen (29)

1 ToNIC - Toulouse NeuroImaging Center
2 Service d'anesthésie et de réanimation [Hôpital de la Timone - APHM]
3 INT - Institut de Neurosciences de la Timone
4 CHU Pitié-Salpêtrière [AP-HP]
5 Service d'anesthésie et réanimation chirurgicale [Nantes]
6 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
7 GIN - [GIN] Grenoble Institut des Neurosciences
8 Hôpital neurologique et neurochirurgical Pierre Wertheimer [CHU - HCL]
9 Service de Réanimation Médicale [CHU Bordeaux]
10 RMN et optique : De la mesure au biomarqueur
11 Service de réanimation pédiatrique
12 HFME - Hôpital Femme Mère Enfant [CHU - HCL]
13 Service d'Anesthésie Réanimation Chirurgicale [Poitiers]
14 PHAR [Poitiers] - Pharmacologie des anti-infectieux
15 Service d'anesthésie-réanimation [Centre Hospitalier Lyon Sud - HCL]
16 Fondation Ophtalmologique Adolphe de Rothschild [Paris]
17 Hôpital Raymond Poincaré [AP-HP]
18 Grenoble - Pôle anesthésie-réanimation
19 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
20 IPMC - Institut de pharmacologie moléculaire et cellulaire
21 Service d'Anesthésie et de Soins Intensifs [Bicêtre]
22 TIGER - Translational and Integrative Group in Epilepsy Research
23 UMRESTTE UMR T9405 - Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement
24 Service d'Anesthésie Réanimation [CHU Necker]
25 EA_7323 - Evaluation thérapeutique et pharmacologie périnatale et pédiatrique
26 Service d'anesthésie - réanimation chirurgicale [CHU de Dijon]
27 Hôpital de Hautepierre [Strasbourg]
28 HCL - Hospices Civils de Lyon
29 Clinique de réanimation médicale

The latest French Guidelines for the management in the first 24 hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société francaise d’anesthésie et de réanimation [SFAR]) in partnership with the Association de neuro-anesthésie-réanimation de langue française (ANARLF), The French Society of Emergency Medicine (Société française de médecine d'urgence (SFMU), the Société française de neurochirurgie (SFN), the Groupe francophone de réanimation et d’urgences pédiatriques (GFRUP) and the Association des anesthésistes-réanimateurs pédiatriques d’expression française (ADARPEF). The method used to elaborate these guidelines was the Grade® method. After two Delphi rounds, 32 recommendations were formally developed by the experts focusing on the evaluation the initial severity of traumatic brain injury, the modalities of prehospital management, imaging strategies, indications for neurosurgical interventions, sedation and analgesia, indications and modalities of cerebral monitoring, medical management of raised intracranial pressure, management of multiple trauma with severe traumatic brain injury, detection and prevention of post-traumatic epilepsia, biological homeostasis (osmolarity, glycaemia, adrenal axis) and paediatric specificities.

Domaines: Médecine humaine et pathologie; Neurosciences [q-bio.NC]

Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, et al.. Management of severe traumatic brain injury (first 24 hours). Anaesthesia Critical Care & Pain Medicine, 2018, 37 (2), pp.171-186. ⟨10.1016/j.accpm.2017.12.001⟩. ⟨hal-01788068⟩