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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1779430
Review Article

Brain Tissue Oxygenation Guided Therapy in Patients with Traumatic Brain Injury: An Umbrella Review of Systematic Review and Meta-Analysis

Babita Raghuwanshi
1   Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
,
William A. Florez-Perdomo
2   Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
,
Rakesh Mishra
3   Department of Neurosurgery, Bhopal Memorial Hospital and Research Centre, Bhopal, Madhya Pradesh, India
,
Luis Rafael Moscote-Salazar 
2   Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
,
Rafael Cincu
4   Department of Neurosurgery, General University Hospital, Valencia, Spain
,
Amit Agrawal 
5   Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
› Author Affiliations Funding None.
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Abstract

The present umbrella review aims to summarize the evidence of the efficacy and benefit of combined brain tissue oxygen monitoring and intracranial pressure (ICP) monitoring compared with ICP monitoring based therapy alone. In this study, we systematically searched five databases to retrieve systematic reviews (SRs) regarding the efficacy of ICP monitoring on patient outcomes following traumatic brain injury (TBI). This overview was prepared following the guidelines established by the Joanna Briggs Institute (JBI) for umbrella reviews. No restrictions were placed on the date, language, or country of publication. Three SRs and meta-analyses met the inclusion criteria for the study. The SRs and meta-analyses (SR-MAs) included randomized controlled trials (RCTs) and observational studies. Specifically, two SRs were rated as high quality by A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2), while one was rated as moderate quality. Two of the SR-MAs reported on the mortality outcome, with two reporting on the functional outcome and one reporting on the length of hospital stay outcome. One of the SRs indicated that using combined brain tissue oxygen monitoring led to a reduction in mortality. Two of the SRs had mixed results. Two articles found that hospital length tends to be shorter with combined therapy than with ICP monitoring-based therapy alone. Our observations suggested that brain tissue oxygen combined with ICP/cerebral perfusion pressure (CPP) guided therapy provides a favorable outcome in TBI patients than standard ICP-/CPP-guided therapy. The combined therapy has little effect on mortality rate, ICP, CPP, and length of stay.

Keywords

brain tissue oxygen - intracranial pressure - monitoring - traumatic brain injury - outcome


Publication History

Article published online:
14 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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