{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:20:20Z","timestamp":1773303620053,"version":"3.50.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,10,24]],"date-time":"2012-10-24T00:00:00Z","timestamp":1351036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2013,1]]},"abstract":"Background<\/jats:title>Traumatic brain injury (TBI<\/jats:styled-content>) treatment protocols have been introduced in the intensive care unit (ICU<\/jats:styled-content>) to avoid secondary brain injury. In this study, we aimed to evaluate the deviations from such a treatment protocol and the frequency of extracranial complications, and relate these findings to outcome.<\/jats:p><\/jats:sec>Methods<\/jats:title>During a 5\u2010year period (2004\u20132009), 133 patients with severe TBI<\/jats:styled-content> [G<\/jats:styled-content>lasgow C<\/jats:styled-content>oma S<\/jats:styled-content>cale (GCS<\/jats:styled-content>) score\u2009\u2264\u20098] were prospectively included. The following deviations from treatment goals were studied: intracranial pressure (ICP<\/jats:styled-content>), blood pressure, haemoglobin, blood glucose, serum sodium, serum albumin, body temperature and extracranial complications during the ICU<\/jats:styled-content> stay. Outcome was assessed using G<\/jats:styled-content>lasgow O<\/jats:styled-content>utcome S<\/jats:styled-content>cale E<\/jats:styled-content>xtended score at 12 months.<\/jats:p><\/jats:sec>Results<\/jats:title>The frequencies of deviations from the treatment goals were: episodes of intracranial hypertension 69.5% (of monitored patients), hypotension 20.3%, anaemia 77.4%, hyperglycaemia 42.9%, hyponatremia 34.6%, hypoalbuminemia 30.8% and hyperthermia 54.9%. Pulmonary complications were common (pneumonia 72.2%, acute respiratory distress syndrome\/acute lung injury 31.6%). Thrombocytopenia (4.5%), severe sepsis (3.0%), renal failure (0.8%) and liver failure (0.8%) were infrequent. Twenty\u2010six (19.5%) patients died within the first 12 months due to the head injury. Age, GCS<\/jats:styled-content> score, pupil dilation, I<\/jats:styled-content>njury S<\/jats:styled-content>everity S<\/jats:styled-content>core (ISS<\/jats:styled-content>), ICP<\/jats:styled-content>\u2009>\u200925\u2009mmHg, hyperglycaemia and pneumonia predicted a worse outcome.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Deviations from the TBI<\/jats:styled-content> treatment protocol were frequent. Pneumonia was the most frequent extracranial complication. Age, GCS<\/jats:styled-content> score, pupil dilation, ISS<\/jats:styled-content>, high ICP<\/jats:styled-content>, hyperglycaemia and pneumonia predicted a worse outcome.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1399-6576.2012.02785.x","type":"journal-article","created":{"date-parts":[[2012,10,24]],"date-time":"2012-10-24T11:31:22Z","timestamp":1351078282000},"page":"46-55","source":"Crossref","is-referenced-by-count":36,"title":["Intensive care and traumatic brain injury after the introduction of a treatment protocol: a prospective study"],"prefix":"10.1111","volume":"57","author":[{"given":"K.","family":"SCHIRMER\u2010MIKALSEN","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Acute Medicine St.Olav University Hospital Trondheim Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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