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:
CreatorsEmailORCIDORCID Put Code
Huijben, Jilske A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van der Jagt, MathieuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cnossen, Maryse C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kruip, Marieke J. H. A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haitsma, Iain K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stocchetti, NinoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maas, Andrew I. R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Menon, David K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ercole, AriUNSPECIFIEDorcid.org/0000-0001-8350-8093UNSPECIFIED
Maegele, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stanworth, Simon J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Citerio, GiuseppeUNSPECIFIEDorcid.org/0000-0002-5374-3161UNSPECIFIED
Polinder, SuzanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steyerberg, Ewout W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lingsma, Hester F.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
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:
KeywordsLanguage
PROTHROMBIN COMPLEX CONCENTRATE; CLINICAL-PRACTICE; CELL TRANSFUSION; COAGULOPATHY; MORTALITY; ANTICOAGULATION; ASSOCIATION; PROPHYLAXIS; OXYGENATION; HEMORRHAGEMultiple languages
Critical Care Medicine; Clinical Neurology; NeurosciencesMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/20519

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