Wiener klinische Wochenschrift
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Wien. Klin. Wochenschr. · Feb 2007
Multicenter StudySevere traumatic brain injury in Austria I: introduction to the study.
The goals of the Austrian Severe Traumatic Brain Injury Study were to investigate the current management of patients with severe traumatic brain injury in Austria and to assess the effects of introducing guidelines for the management of severe traumatic brain injury upon the outcome of these patients. The purpose of this paper is to give a detailed description of the goals, methods, and overall results of the study, and to provide an introduction to a series of papers where the results of the study will be presented and discussed. ⋯ This study proved that an internet-based database may be a valuable tool for prospective multicenter studies if many variables have to be collected for a high number of patients. The results of our study provide enough evidence to initiate further research on many aspects of the management of traumatic brain injury patients.
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Wien. Klin. Wochenschr. · Feb 2007
Multicenter StudySevere traumatic brain injury in Austria II: epidemiology of hospital admissions.
The goal of this paper is to describe the hospital-based epidemiology of severe TBI in Austria. ⋯ Epidemiology of severe traumatic brain injuries in Austria is not much different from other industrialized countries. Traffic accidents are responsible for the majority of traumas, stressing the importance of road injury prevention. Attention should also be paid to the specific risks of older people and to prevent injuries at home.
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Wien. Klin. Wochenschr. · Feb 2007
Multicenter StudySevere traumatic brain injury in Austria VI: effects of guideline-based management.
The goal of this paper is to report relations between health outcomes and implementation of individual recommendations of the guidelines. ⋯ The relatively strong relation between initial resuscitation in the hospital and ICU survival provides a firm basis for future efforts of emergency teams. The positive influence of some of the recommendations on reduction of ICU or hospital days may provide economic incentives to promote guidelines implementation.
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Wien. Klin. Wochenschr. · Feb 2007
Multicenter StudySevere traumatic brain injury in Austria V: CT findings and surgical management.
The aim of this paper is to describe CT findings and surgical management of patients with severe traumatic brain injury (TBI) in Austria. ⋯ ICP monitoring seems to be beneficial in both operatively and non-operatively treated patients with severe TBI. Patients with SDH who were operated on had significantly better outcomes. In patients with SDH, their outcome after osteoclastic surgery was significantly better than after osteoplastic procedures.
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Wien. Klin. Wochenschr. · Feb 2007
Multicenter StudySevere traumatic brain injury in Austria IV: intensive care management.
The goal of this paper is to describe the ICU management of severe traumatic brain injury (TBI) in Austria. ⋯ Our study showed that ICU management of patients with severe TBI mostly follows international guidelines, and that outcome was comparable to or even better than that reported by other authors. Low CPP was associated with poor outcome, and was more often due to low MAP than to elevated ICP. The use of barbiturates and hypertonic saline was more common than expected. CPP should be maintained > 50 mm Hg, the use of catecholamines, fluid loading, barbiturates (short-term), moderate hyperventilation, hypertonic saline, and insulin may improve outcome after severe TBI.