Universität zu Köln

Huijben, Jilske A., van der Jagt, Mathieu, Cnossen, Maryse C., Kruip, Marieke J. H. A., Haitsma, Iain K., Stocchetti, Nino, Maas, Andrew I. R., Menon, David K., Ercole, Ari ORCID: 0000-0001-8350-8093, Maegele, Marc, Stanworth, Simon J., Citerio, Giuseppe ORCID: 0000-0002-5374-3161, Polinder, Suzanne, Steyerberg, Ewout W. and Lingsma, Hester F. (2018). Variation in Blood Transfusion and Coagulation Management in Traumatic Brain Injury at the Intensive Care Unit: A Survey in 66 Neurotrauma Centers Participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Study. J. Neurotrauma, 35 (2). S. 323 - 333. NEW ROCHELLE: MARY ANN LIEBERT, INC. ISSN 1557-9042

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Abstract

Our aim was to describe current approaches and to quantify variability between European intensive care units (ICUs) in patients with traumatic brain injury (TBI). Therefore, we conducted a provider profiling survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The ICU Questionnaire was sent to 68 centers from 20 countries across Europe and Israel. For this study, we used ICU questions focused on 1) hemoglobin target level (Hb-TL), 2) coagulation management, and 3) deep venous thromboembolism (DVT) prophylaxis. Seventy-eight participants, mostly intensivists and neurosurgeons of 66 centers, completed the ICU questionnaire. For ICU-patients, half of the centers (N=34; 52%) had a defined Hb-TL in their protocol. For patients with TBI, 26 centers (41%) indicated an Hb-TL between 70 and 90g/L and 38 centers (59%) above 90g/L. To treat trauma-related hemostatic abnormalities, the use of fresh frozen plasma (N=48; 73%) or platelets (N=34; 52%) was most often reported, followed by the supplementation of vitamin K (N=26; 39%). Most centers reported using DVT prophylaxis with anticoagulants frequently or always (N=62; 94%). In the absence of hemorrhagic brain lesions, 14 centers (21%) delayed DVT prophylaxis until 72h after trauma. If hemorrhagic brain lesions were present, the number of centers delaying DVT prophylaxis for 72h increased to 29 (46%). Overall, a lack of consensus exists between European ICUs on blood transfusion and coagulation management. The results provide a baseline for the CENTER-TBI study, and the large between-center variation indicates multiple opportunities for comparative effectiveness research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Huijben, Jilske A. UNSPECIFIED UNSPECIFIED UNSPECIFIED van der Jagt, Mathieu UNSPECIFIED UNSPECIFIED UNSPECIFIED Cnossen, Maryse C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kruip, Marieke J. H. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Haitsma, Iain K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stocchetti, Nino UNSPECIFIED UNSPECIFIED UNSPECIFIED Maas, Andrew I. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Menon, David K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ercole, Ari UNSPECIFIED orcid.org/0000-0001-8350-8093 UNSPECIFIED Maegele, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Stanworth, Simon J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Citerio, Giuseppe UNSPECIFIED orcid.org/0000-0002-5374-3161 UNSPECIFIED Polinder, Suzanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Steyerberg, Ewout W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lingsma, Hester F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-205194
DOI:	10.1089/neu.2017.5194
Journal or Publication Title:	J. Neurotrauma
Volume:	35
Number:	2
Page Range:	S. 323 - 333
Date:	2018
Publisher:	MARY ANN LIEBERT, INC
Place of Publication:	NEW ROCHELLE
ISSN:	1557-9042
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PROTHROMBIN COMPLEX CONCENTRATE; CLINICAL-PRACTICE; CELL TRANSFUSION; COAGULOPATHY; MORTALITY; ANTICOAGULATION; ASSOCIATION; PROPHYLAXIS; OXYGENATION; HEMORRHAGE Multiple languages Critical Care Medicine; Clinical Neurology; Neurosciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20519