Recommendations for the Critical Care Management of Devastating Brain Injury: Prognostication, Psychosocial, and Ethical Management: A Position Statement for Healthcare Professionals from the Neurocritical Care Society

Michael J. Souter, Patricia A. Blissitt, Sandralee Blosser, Jordan Bonomo, David Greer, Draga Jichici, Dea Mahanes, Evie G. Marcolini, Charles Miller, Kiranpal Sangha, Susan Yeager

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

Devastating brain injuries (DBIs) profoundly damage cerebral function and frequently cause death. DBI survivors admitted to critical care will suffer both intracranial and extracranial effects from their brain injury. The indicators of quality care in DBI are not completely defined, and despite best efforts many patients will not survive, although others may have better outcomes than originally anticipated. Inaccuracies in prognostication can result in premature termination of life support, thereby biasing outcomes research and creating a self-fulfilling cycle where the predicted course is almost invariably dismal. Because of the potential complexities and controversies involved in the management of devastating brain injury, the Neurocritical Care Society organized a panel of expert clinicians from neurocritical care, neuroanesthesia, neurology, neurosurgery, emergency medicine, nursing, and pharmacy to develop an evidence-based guideline with practice recommendations. The panel intends for this guideline to be used by critical care physicians, neurologists, emergency physicians, and other health professionals, with specific emphasis on management during the first 72-h post-injury. Following an extensive literature review, the panel used the GRADE methodology to evaluate the robustness of the data. They made actionable recommendations based on the quality of evidence, as well as on considerations of risk: benefit ratios, cost, and user preference. The panel generated recommendations regarding prognostication, psychosocial issues, and ethical considerations.

Original languageEnglish (US)
Pages (from-to)4-13
Number of pages10
JournalNeurocritical Care
Volume23
Issue number1
DOIs
StatePublished - Aug 3 2015

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Recommendations for the Critical Care Management of Devastating Brain Injury: Prognostication, Psychosocial, and Ethical Management: A Position Statement for Healthcare Professionals from the Neurocritical Care Society'. Together they form a unique fingerprint.

Cite this