{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:32:36Z","timestamp":1789147956182,"version":"build-2803163510"},"reference-count":30,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,3,24]],"date-time":"2024-03-24T00:00:00Z","timestamp":1711238400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Intensive Care Society"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>Decompressive craniectomy (DC) involves surgical removal of the skull that overlies swollen, imperiled, brain. This is done to combat intracranial hypertension and mitigate a vicious cycle of secondary brain injury. If, instead, this pathophysiology goes uninterrupted, it can mean brain herniation and brain stem death. As such, DC can save lives when all else fails. Regardless, it is no panacea and can also \u201cruin deaths,\u201d and leave patients profoundly disabled. DC is not a new procedure; however, this therapy is increasingly noteworthy due to advances in neurocritical care, alongside ethical concerns. We cover the physiological rationale, the surgical basics, the trial data, and focus on secondary decompression (for refractory intracranial pressure (ICP)) rather than primary decompression (i.e. during evacuation of an intracranial mass). Given that DC should not be undertaken indiscriminately, we conclude by introducing ways in which to discuss DC with families and colleagues. Our goal is to provide a primer and common resource for the multidisciplinary team. We aim to increase not only knowledge but wisdom, prudence, collegiality, and family-focused care.<\/jats:p>","DOI":"10.1177\/17511437241237760","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T00:30:27Z","timestamp":1711326627000},"page":"339-345","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Decompressive craniectomy: A primer for acute care practitioners"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7585-3591","authenticated-orcid":false,"given":"Peter George","family":"Brindley","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sanderson","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1078-7217","authenticated-orcid":false,"given":"Dustin","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cian","family":"O\u2019Kelly","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,24]]},"reference":[{"key":"bibr1-17511437241237760","first-page":"161","volume":"2","author":"Paulson OB","year":"1990","journal-title":"Cerebrovasc Brain Metab Rev"},{"key":"bibr2-17511437241237760","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7721"},{"key":"bibr3-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1177\/0885066615601607"},{"key":"bibr4-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1177\/08850666231156589"},{"key":"bibr5-17511437241237760","volume":"26","author":"Rangel-Castilla L","year":"2008","journal-title":"Neurol Clin"},{"key":"bibr6-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-015-0144-7"},{"key":"bibr7-17511437241237760","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.00458"},{"key":"bibr8-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-09695-6"},{"key":"bibr9-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-015-0155-6"},{"key":"bibr10-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.032359"},{"key":"bibr11-17511437241237760","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21207609"},{"key":"bibr12-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003200"},{"key":"bibr13-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70047-X"},{"key":"bibr14-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.485649"},{"key":"bibr15-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1311367"},{"key":"bibr16-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.485235"},{"key":"bibr17-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-012-9703-3"},{"key":"bibr18-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70036-4"},{"key":"bibr19-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102077"},{"key":"bibr20-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1605215"},{"key":"bibr21-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.1070"},{"key":"bibr22-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2214172"},{"key":"bibr23-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1186\/cc8178"},{"key":"bibr24-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-08959-y"},{"key":"bibr25-17511437241237760","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2012.10.031"},{"key":"bibr26-17511437241237760","unstructured":"Brain Trauma Foundation. 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