Abstract

When the fourth edition of the Brain Trauma Foundation's Guidelines for the Management of Severe Traumatic Brain Injury were finalized in late 2016, it was known that the results of the RESCUEicp (Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension) randomized controlled trial of decompressive craniectomy would be public after the guidelines were released. The guideline authors decided to proceed with publication but to update the decompressive craniectomy recommendations later in the spirit of “living guidelines,” whereby topics are updated more frequently, and between new editions, when important new evidence is published. The update to the decompressive craniectomy chapter presented here integrates the findings of the RESCUEicp study as well as the recently published 12-mo outcome data from the DECRA (Decompressive Craniectomy in Patients With Severe Traumatic Brain Injury) trial. Incorporation of these publications into the body of evidence led to the generation of 3 new level-IIA recommendations; a fourth previously presented level-IIA recommendation remains valid and has been restated. To increase the utility of the recommendations, we added a new section entitled Incorporating the Evidence into Practice. This summary of expert opinion provides important context and addresses key issues for practitioners, which are intended to help the clinician utilize the available evidence and these recommendations.The full guideline can be found at: https://braintrauma.org/guidelines/guidelines-for-the-management-of-severe-tbi-4th-ed#/.

中文翻译：

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Winograd等人的勘误表：“一种有效而实用的限制液流的方案，以减少经蝶窦手术后低钠血症和再入院的风险”。神经外科，nyz555，https://doi.org/10.1093/neuros/nyz555。

摘要

当2016年末《脑创伤基金会第四版严重创伤性脑损伤处理指南》最终定稿时，众所周知，减压颅骨切除术RESCUEicp（颅内压减压颅骨切除术试验）随机对照试验的结果将是准则发布后公开。指南作者决定继续出版，但本着“生活指南”的精神，稍后再更新减压颅骨切除术的建议，即在发表重要的新证据时，主题会更频繁地更新。此处介绍的减压颅骨切除术章节的更新内容整合了RESCUEicp研究的结果以及DECRA（严重颅脑损伤患者的减压颅骨切除术）试验最近发表的12个月结果数据。将这些出版物纳入证据体系，产生了3项新的IIA级建议；先前提出的第四条IIA级建议仍然有效，并已重述。为了增加建议的效用，我们增加了一个新的部分，标题为将证据纳入实践。该专家意见摘要为从业人员提供了重要的背景信息并解决了关键问题，旨在帮助临床医生利用现有证据和这些建议。完整的指南可在以下网址找到：https：//braintrauma.org/guidelines/guidelines-对于严重的tbi-4版的管理＃/。