• Shu Utsumi, Kie Okajima, and Shunsuke Amagasa.
• Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; Department of Emergency and Transport Medicine, National Center for Child Health and Development, Tokyo, Japan. Electronic address: shu8109@gmail.com.
• World Neurosurg. 2024 Oct 1; 190: 481486.e2481-486.e2.

AbstractIntracranial pressure (ICP) monitoring and monitoring of brain tissue oxygen (Pbto2) in addition to ICP have been used in the management of traumatic brain injury (TBI). However, the optimal monitoring method is inconclusive. We searched 4 databases with no language restrictions through January 2024 for peer-reviewed randomized controlled trials (RCTs) comparing ICP monitoring with combined Pbto2 and ICP monitoring in patients with traumatic brain injury. A favorable neurologic outcome was the primary outcome, and the secondary outcome was survival. Two reviewers screened manuscripts, extracted data, and assessed the risk of bias. We then performed a meta-analysis to assess efficacy using the Grading of Recommendations, Assessment, Development, and Evaluation working group approach. We included 5 trials comprising 512 patients. There was no difference in favorable neurologic outcome (risk ratio: 1.21; 95% confidence interval: 0.93, 1.58; I2: 45%; 5 RCTs: 512 patients; moderate certainty) and survival (risk ratio: 1.10; 95% confidence interval: 0.99, 1.21; I2: 13%; 5 RCTs: 512 patients; moderate certainty). We found no evidence that the combination of Pbto2 and ICP is more useful than ICP. The included RCTs are few and small, and further study is needed to draw conclusions.Copyright © 2024 Elsevier Inc. All rights reserved.

17 keywords...

hide…