The most severe traumatic brain injuries (TBI) require admission to intensive care. The critical care management of patients with TBI may require urgent surgery or invasive monitoring of brain physiology such as intracranial pressure (ICP) and brain tissue oxygen (PbtO2). Continuous electroencephalography (cEEG) or intracranial electrocorticography (ECOG) may be used to detect seizures or spreading depolarizations. However, there are many unanswered questions about the comparative effectiveness of monitoring and management strategies used for these complex patients. Our overall goal is to improve the outcomes of patients with TBI requiring intensive care.
The ICU TBI Group is working to 1) Curate a unique set of electronic medical record (EMR)-level physiologic data tied to clinical interventions 2) Utilize novel data capture, upload, and formatting methods to create high-resolution and time-locked data from multiple brain and body sensors. Using these data sets in conjunction with TRACK-TBI’s clinical and outcome data, the aims of the ICU TBI Group are to 1) Understand critical care practice variability across TRACK-TBI sites, 2) Define the impact of ICP on clinically-meaningful outcomes, including cognition, and 3) Develop a better understanding of brain physiology after TBI by exploring autoregulatory dysfunction, brain tissue hypoxia, seizures, and spreading depolarizations.