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Review
. 2024 Apr 15;9(Suppl 2):e001382.
doi: 10.1136/tsaco-2024-001382. eCollection 2024.

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Tanya Egodage  1 , Purvi Pravinchandra Patel  2   3
Affiliations
Review

Updates in traumatic brain injury management: brain oxygenation, middle meningeal artery embolization and new protocols

Tanya Egodage et al. Trauma Surg Acute Care Open. .

Abstract

Traumatic brain injury (TBI) confers significant morbidity and mortality, and is a pathology often encountered by trauma surgeons. Several recent trials have evaluated management protocols of patients with severe TBI. The Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II trial (BOOST-II) evaluated efficacy and feasibility of brain oxygen measurement in severe TBI. BOOST phase 3 trial (BOOST-3) and two ongoing trials look to measure functional outcomes in this population. Furthermore, middle meningeal artery embolization has now become standard therapy for adult patients with chronic subdural hematoma (SDH) and has increasing popularity in those with recurrent SDH as an alternative to surgical intervention. In this manuscript, we review the literature, ongoing trials, and discuss current updates in the management of TBI.

Keywords: Brain Injuries, Traumatic; Clinical Protocols; Head Injuries, Closed; randomized controlled trial.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
THE MANTLE recommendations for optimization of cerebral oxygenation. Adopted from Godoy DA, et al. SvjO2, venous jugular oxygen content; PtiO2, partial pressure of brain tissue oxygen; CPP, cerebral perfusion pressure; SABP, systolic arterial blood pressure; PaO2, arterial partial pressure of oxygen; Vt, tidal volume; RR, respiratory rate; PP, plateau pressure; DP, driving pressure; PI, pulsatility index; MP, mechanical power; ICP, intracranial pressure; ONSD, optic nerve sheath diameter; CT, computed tomography.
See this image and copyright information in PMC

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