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Decision-making in very severe traumatic brain injury
EVIDENCE SYNTHESIS
The search resulted in 2568 manuscripts. After screening of abstracts, 751 studies were 2 selected for full-text assessment. Manuscripts were excluded for three main reasons: 1)
no original data (N.=173); 2) no vs-TBI patient cohort (N.=504); 3) no surgical treatment
or outcome specified for vs-TBI (N.=29) and other reasons (N.=6). Finally, 39 scientific manuscripts met inclusion criteria. After checking reference lists on possible relevant publications another 6 emerged, resulting in a final selection of 45 studies 15-20 (Figure
1). In addition, a total of 126 manuscripts formed the evidence base for the sections on penetrating brain injury.
Figure 1: Article selection
Intracranial pressure monitoring
Eight studies from all global continents reported results of ICP guided treatment in vs-TBI patients (Table I).21-28 Only three studies reported prospective data collection.21-23 Cohort sizes varied between 78 and 4880 patients,24, 25 presenting male dominance (mean 77%) and young age (mean 42 years).
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