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2 Minute Medicine Rewind March 11, 2024 | 2 Minute Medicine

Early vs Late Fixation of Extremity Fractures Among Adults With Traumatic Brain Injury 1. In a cohort of patients with traumatic brain injury, early fixation of extremity fractures within 24 hours of injury was not associated with greater rates of unfavourable functional outcomes at 6 months. Evidence Rating: 2 (Good) While extremity fractures are commonly

United-states , Canada , Minute-medicine-inc , Traumatic-brain-injury , Glasgow-outcome-scale-extended , Cancer-screening-trial , Rating-level , Hispanic-black , Better-outcomes-registry , Colon-cancer , Critical-care

Extracranial Surgery, Anesthesia After TBI Tied to Poorer Clinical Outcomes

Undergoing extracranial surgery and anesthesia post-traumatic brain injury are associated with poorer functional and cognitive outcomes.

Spain , Spanish , Common-data-element-neuroimaging-working-group , National-institute-of-neurological-disorders , Transforming-research , Clinical-knowledge , Traumatic-brain-injury , National-institute , Neurological-disorders , Glasgow-outcome-scale-extended , Trail-making-test-parts

Extracranial Surgery, Anesthesia After TBI Tied to Poorer Clinical Outcomes

Undergoing extracranial surgery and anesthesia post-traumatic brain injury are associated with poorer functional and cognitive outcomes.

Spain , Spanish , National-institute-of-neurological-disorders , Common-data-element-neuroimaging-working-group , Transforming-research , Clinical-knowledge , Traumatic-brain-injury , National-institute , Neurological-disorders , Glasgow-outcome-scale-extended , Trail-making-test-parts

Therapeutic Hypothermia May Not Benefit Cardiac Arrest Patients

Mortality, functional outcomes similar to normothermia in patients with nonshockable rhythm

Boston-university , Massachusetts , United-states , Australia , Belgium , New-zealand , Fabio-silvio-taccone , David-greer , Sophie-putka , Universitaire-de-bruxelles , William-spears , Glasgow-outcome-scale-extended

Deep Brain Stimulation Revives Cognitive Function After Traumatic Brain Injury

Pilot study shows promise in people with chronic cognitive deficits

Stanford , California , United-states , New-york , Nicholas-schiff , Judy-george , Jaimie-henderson , Stanford-medicine , Weill-cornell-medicine , New-york-city , Coma-scale

Neurological Pupil Index Prognostic of Outcomes, Mortality in Acute Brain Injury

The Neurological Pupil index may be a valuable method for predicting neurologic outcomes and mortality following an acute brain injury.

Neurological-pupil , Acute-brain-injury-with , Glasgow-outcome-scale-extended , Glasgow-coma-scale ,

Repetitive Traumatic Brain Injuries Lead to Profound Cumulative Deficits

Worse longitudinal outcomes of mental health, quality of life, functional disability, and physical well-being with repetitive TBIs.

United-states , Patient-health , Transforming-research , Clinical-knowledge , Traumatic-brain-injury , Glasgow-outcome-scale-extended , Rivermead-post-concussion-symptoms-questionnaire , Brief-symptom , Life-after-brain-injury-overall-scale , Statistical-manual , Mental-disorders

Repetitive Traumatic Brain Injuries Lead to Profound Cumulative Deficits

Worse longitudinal outcomes of mental health, quality of life, functional disability, and physical well-being for individuals with repetitive TBIs.

United-states , Patient-health , Transforming-research , Clinical-knowledge , Traumatic-brain-injury , Glasgow-outcome-scale-extended , Rivermead-post-concussion-symptoms-questionnaire , Brief-symptom , Life-after-brain-injury-overall-scale , Statistical-manual , Mental-disorders

"The impact of brain tissue oxygenation monitoring on the Glasgow Outco" by Ruth Shanahan, Pinar Avsar et al.

Background: Traumatic brain injuries (TBIs) are one of the leading causes of death or long-term disability around the world. As a result of improvements in supportive care, patients are surviving more severe insults with more pronounced dependency on their families, hospitals, and long-term care facilities. The introduction of brain tissue oxygenation (PbtO2) monitoring aims to recognize episodes of reduced cerebral perfusion with and without associated increased intracranial pressure (ICP). Aim: The aim of this review is to determine the impact of PbtO2 on the Glasgow Outcome Scale/Glasgow Outcome Scale Extended (GOS/GOSE) in patients with moderate to severe TBI. Design: Systematic review with narrative and meta-analysis. All original research in which adult patients undergoing PbtO2 were compared with a control group of traditional ICP/cerebral perfusion pressure (CPP) monitoring. Both randomized controlled trials and observational studies were included in this review. Methods: Databases were searched in September 2022. The primary outcome of the review was the impact of PbtO2 monitoring on GOS/GOSE, while secondary outcomes were mortality and length of stay (LOS) in the intensive care unit (ICU). Results: Seven studies with a combined number of 770 patients were included in the review. These patients were adults ≥16 years of age. Only two of the studies included found a statistically significant association between PbtO2 monitoring and improved long-term neurological outcomes in patients with TBI (p =.01, p <.01). A meta-analysis of the secondary outcomes identified an associated reduction of mortality in favour of the group treated with PbtO2 monitoring (p <.0001). Results from studies examining LOS in ICU have demonstrated an associated increase of LOS in ICU in patients treated with PbtO2-guided therapy. Conclusion: From the studies included in this review, only two found a statistically significant association between PbtO2 monitoring and long-term outcomes. It is unclear whether PbtO2 goal-directed therapy has a positive impact on the long-term neurological functions and mortality of patients suffering from TBI. A multicentre randomized controlled trial may provide further evidence, but not necessarily conclusive. Relevance to Clinical Practice: Further research is warranted to determine the efficacy of the introduction of this new monitoring system to guide local policy change.

Glasgow-outcome , Glasgow-outcome-scale-extended , Clinical-practice , Brain-tissue-oxygenation-monitoring , Ritical-care , Lasgow-outcome-scale-glasgow-extended , Ystematic-review , Raumatic-brain-injury ,

Neurological Pupil Index Prognostic of Outcomes, Mortality in Acute Brain Injury

The Neurological Pupil index may be a valuable method for predicting neurologic outcomes and mortality following an acute brain injury.

Neurological-pupil , Acute-brain-injury-with , Glasgow-outcome-scale-extended , Glasgow-coma-scale ,