Traumatic Brain Injury, Current Clinical Management Strategies in ICU: Hands on Manual
Downloads
Traumatic brain injury (TBI) is a leading cause of morbidity and mortality, frequently requiring intensive care unit (ICU) management. Current ICU strategies aim to prevent secondary brain injury through early stabilization and continuous neurological monitoring. Initial care focuses on airway protection, adequate ventilation, and hemodynamic stability to ensure sufficient cerebral oxygenation. Intracranial pressure (ICP) monitoring guides targeted interventions to control intracranial hypertension. Maintenance of optimal cerebral perfusion pressure is achieved through fluid management and vasopressor support when necessary. Due to the severity of the social economic health related issue is important to carefully provide veritable guide to doctors especially intensivist on the current protocol from years of experience of different scholars, local and internationally accepted guidelines to serve as a hand on local protocol of management of TBI in the intensive care unit. This manual is based on existing regulatory documents and international accepted method of managing TBI, special and detailed emphases is placed on careful calculation of fluid balance and maximising fluid administration through the enteral route. Overall, ICU management of TBI emphasizes multidisciplinary, protocol-driven care to improve neurological outcomes.
1. Bushnik, T., Hanks, R. A., Kreutzer, J., & Rosenthal, M. (2003). Etiology of traumatic brain injury: Characterization of differential outcomes up to 1 year postinjury. Archives of Physical Medicine and Rehabilitation, 84(2), 255–262. https://doi.org/10.1053/apmr.2003.50085
2. Lalwani, S., Hasan, F., Khurana, S., & Mathur, P. (2018). Epidemiological trends of fatal pediatric trauma: A single-center study. Medicine, 97(39), e12280. https://doi.org/10.1097/MD.0000000000012280
3. Lamb, L. C., DiFiori, M., Comey, C., & Feeney, J. (2018). Cost analysis of direct oral anticoagulants compared with warfarin in patients with blunt traumatic intracranial hemorrhages. American Surgeon, 84(6), 1010–1014.
4. Laeke, T., Tirsit, A., Kassahun, A., Sahlu, A., Debebe, T., Yesehak, B., Masresha, S., Deyassa, N., Moen, B. E., Lund-Johansen, M., & Sundstrøm, T. (2021). Prospective study of surgery for traumatic brain injury in Addis Ababa, Ethiopia: Trauma causes, injury types, and clinical presentation. World Neurosurgery, 149, e460–e468. https://doi.org/10.1016/j.wneu.2021.02.003
5. Li, Q., Wang, P., Huang, C., Chen, B., Liu, J., Zhao, M., & Zhao, J. (2019). N-acetyl serotonin protects neural progenitor cells against oxidative stress-induced apoptosis and improves neurogenesis in adult mouse hippocampus following traumatic brain injury. Journal of Molecular Neuroscience, 67(4), 574–588. https://doi.org/10.1007/s12031-019-01275-5
6. Mohammadifard, M., Ghaemi, K., Hanif, H., Sharifzadeh, G., & Haghparast, M. (2018). Marshall and Rotterdam computed tomography scores in predicting early deaths after brain trauma. European Journal of Translational Myology, 28(3), 7542. https://doi.org/10.4081/ejtm.2018.7542
7. Rodríguez-Triviño, C. Y., Torres Castro, I., & Dueñas, Z. (2019). Hypochloremia in patients with severe traumatic brain injury: A possible risk factor for increased mortality. World Neurosurgery, 124, e783–e788. https://doi.org/10.1016/j.wneu.2019.01.051
8. Salehpour, F., Bazzazi, A. M., Aghazadeh, J., Hasanloei, A. V., Pasban, K., Mirzaei, F., & Naseri Alavi, S. A. (2018). What do you expect from patients with severe head trauma? Asian Journal of Neurosurgery, 13(3), 660–663. https://doi.org/10.4103/ajns.AJNS_83_17
9. Schneider, A. L. C., Wang, D., Ling, G., Gottesman, R. F., & Selvin, E. (2018). Prevalence of self-reported head injury in the United States. New England Journal of Medicine, 379(12), 1176–1178. https://doi.org/10.1056/NEJMc1807311
10. Stein, T. D., Alvarez, V. E., & McKee, A. C. (2015). Concussion in chronic traumatic encephalopathy. Current Pain and Headache Reports, 19(10), 47. https://doi.org/10.1007/s11916-015-0518-2
11. Su, E., & Bell, M. (2016). Diffuse axonal injury. In D. Laskowitz & G. Grant (Eds.), Translational research in traumatic brain injury. CRC Press/Taylor & Francis Group.
12. Udoh, M. O., & Ugiagbe, E. E. (Year). A retrospective autopsy-based survey of fatal traumatic brain injuries in Benin City, Nigeria. Journal name not provided.
13. Woo, J., Kendall, N. J., Petitt, Z., Ayantayo, T. O., Atilola, O., Ayodele, O. A., Onyia, C. U., Holden-Kapshuck, S. C., Browning, B. K., Kieny, H. G., Nwaribe, E. E., Oyemolade, T. A., Badejo, O. A., Malomo, T. A., Blackwood, E., von Isenburg, M., Idowu, O. E., Adeleye, A. O., Malomo, A. O., Shokunbi, M. T., Haglund, M. M., & Ukachukwu, A. K. (2025). Management and outcomes of pediatric traumatic brain injury in Nigeria: A systematic review. Journal of Neurosurgery: Pediatrics, 35(6), 627–636. https://doi.org/10.3171/2024.12.PEDS24437

