{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:24:54Z","timestamp":1790799894383,"version":"4.1.0"},"reference-count":102,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T00:00:00Z","timestamp":1640044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Managing the acute phase after a severe traumatic brain injury (TBI) with polytrauma represents a challenging situation for every trauma team member. A worldwide variability in the management of these complex patients has been reported in recent studies. Moreover, limited evidence regarding this topic is available, mainly due to the lack of well-designed studies. Anesthesiologists, as trauma team members, should be familiar with all the issues related to the management of these patients. In this narrative review, we summarize the available evidence in this setting, focusing on perioperative brain protection, cardiorespiratory optimization, and preservation of the coagulative function. An overview on simultaneous multisystem surgery (SMS) is also presented.<\/jats:p>","DOI":"10.3390\/jcm11010018","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T01:08:09Z","timestamp":1640135289000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Perioperative Management of Polytrauma Patients with Severe Traumatic Brain Injury Undergoing Emergency Extracranial Surgery: A Narrative Review"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0316-1451","authenticated-orcid":false,"given":"Edoardo","family":"Picetti","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Parma University Hospital, 43100 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Israel","family":"Rosenstein","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Policlinico Umberto I Hospital, La Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0277-4822","authenticated-orcid":false,"given":"Zsolt J.","family":"Balogh","sequence":"additional","affiliation":[{"name":"Department of Traumatology, John Hunter Hospital, University of Newcastle, Newcastle 2305, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto","family":"Catena","sequence":"additional","affiliation":[{"name":"Department of General and Emergency Surgery, Bufalini Hospital, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio S.","family":"Taccone","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Erasme Hospital, Universit\u00e9 Libre de Bruxelles, 1070 Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fornaciari","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Parma University Hospital, 43100 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Votta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Policlinico Umberto I Hospital, La Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7017-0150","authenticated-orcid":false,"given":"Rafael","family":"Badenes","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, Hospital Cl\u00ecnico Universitario de Valencia, University of Valencia, 46010 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-6646","authenticated-orcid":false,"given":"Federico","family":"Bilotta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Policlinico Umberto I Hospital, La Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/S1474-4422(17)30371-X","article-title":"Traumatic brain injury: Integrated approaches to improve prevention, clinical care, and research","volume":"16","author":"Maas","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_2","first-page":"1080","article-title":"Estimating the global incidence of traumatic brain injury","volume":"30","author":"Dewan","year":"2018","journal-title":"J. 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