Evidence map›Paper›PMID 37171175›Full record

ArticleNeurosurgery2023

Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations.

Randall M Chesnut, Sergio Aguilera, Andras Buki, Eileen M Bulger, Giuseppe Citerio, D Jamie Cooper, Ramon Diaz Arrastia, Michael Diringer, Anthony Figaji, Guoyi Gao and 31 more

Open access · hybridAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurosurgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Review
  3. Update on traumatic brain injury in the ICU.Current opinion in anaesthesiology · 2025
    Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

41 authors at 20 institutions in 15 countries.

Randall M ChesnutDepartment of Neurological Surgery, University of Washington, Seattle, Washington, USA.ORCID 0000-0001-6377-3666
Sergio AguileraAlmirante Nef Naval Hospital, Valparaiso University, Viña Del Mar, Chile.
Andras BukiDepartment of Neurosurgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Eileen M BulgerDepartment of Surgery, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
Giuseppe CiterioSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
D Jamie CooperIntensive Care Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.
Ramon Diaz ArrastiaDepartment of Neurology, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Michael DiringerDepartment of Neurology, Washington University School of Medicine, St Louis, USA.
Anthony FigajiDivision of Neurosurgery and Neuroscience Institute, Groote Schuur Hospital, University of Cape Town, Observatory 7925, South Africa.
Guoyi GaoDepartment of Neurosurgery, Renji Hospital, Shanghai Institute of Head Trauma, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Romergryko G GeocadinDepartments of Neurology, Neurological Surgery, Anesthesiology-Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jamshid GhajarDepartment of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, California, USA.
Odette HarrisDepartment of Neurosurgery, Stanford University School of Medicine, Center for Academic Medicine, Stanford, California, USA.
Gregory W J HawrylukCleveland Clinic Akron General Neurosciences Center, Fairlawn, Ohio, USA.
Alan HofferUH Cleveland Medical Center, Cleveland, Ohio, USA.
Peter HutchinsonDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge and Cambridge Biomedical Campus, Cambridge, UK.
Mathew JosephDepartment of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
Ryan KitagawaVivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, Houston, Texas, USA.
Geoffrey ManleyDepartment of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA.
Stephan MayerWestchester Health Network, New York Medical College, Valhalla, New York, USA.
David K MenonDivision of Anaesthesia, Addenbrooke's Hospital, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK.
Geert MeyfroidtDepartment of Intensive Care Medicine, University Hospitals Leuven and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
Daniel B MichaelDepartment of Neurosurgery, Beaumont Health, Michigan Head and Spine Institute, Oakland University William Beaumont School of Medicine, Southfield, Michigan, USA.
Mauro OddoCHUV Medical Directorate and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
David O OkonkwoDepartment of Neurosurgery, University of Pittsburgh Medical Center Presbyterian, Pittsburgh, Pennsylvania, USA.
Mayur B PatelDepartment of Surgery, Division of Acute Care Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Claudia RobertsonDepartment of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas, USA.
Jeffrey V RosenfeldDepartment of Neurosurgery, Alfred Hospital, Melbourne, Australia.
Andres M RubianoINUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia.
Juain SahuquilloDepartment of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona: Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain.
Franco ServadeiDepartment of Biomedical Sciences, Humanitas University and IRCCS Humanitas Research Hospital, Milano, Italy.
Lori ShutterDepartment of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Deborah M SteinUniversity of Maryland School of Medicine, Adult Critical Care Services, University of Maryland Medical Center, Baltimore, Maryland, USA.
Nino StocchettiDepartment of Physiopathology and Transplantation, Milan University, Milan, Italy.
Fabio Silvio TacconeDepartment of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Shelly D TimmonsDepartment of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Eve C TsaiSuruchi Bhargava Chair in Spinal Cord and Brain Regeneration Research, The Ottawa Hospital, Department of Surgery, Division of Neurosurgery, University of Ottawa, Civic Campus, Ottawa, Ontario, Canada.
Jamie S UllmanDepartment of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, North Shore University Hospital, Manhasset, New York, USA.
Walter VidettaIntensive Care, Posadas Hospital, Buenos Aires, Argentina.
David W WrightDepartment of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Christopher ZammitDepartment of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA.
The Alfred Hospital · AUUniversity of Cambridge · GBUniversity of Washington · USAzienda Ospedaliera San Gerardo · ITBarnes-Jewish Hospital · USBaylor College of Medicine · USBrain Trauma Foundation · USChristian Medical College, Vellore · INEmory University · USHospital Naval Almirante Nef · CLHospital Posadas · ARHumanitas University · ITJohns Hopkins University · USKU Leuven · BENeurological Surgery · USNorth Shore University Hospital · USOakland University · USÖrebro University · SEPenn Presbyterian Medical Center · USRenji Hospital · CN

Funding

Medical Research Council G9439390
6 · The paper itself

Abstract

backgroundIntracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed.

objectiveTo study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion.

methodsWe polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression.

resultsHeatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations.

conclusionCandidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.

Indexed as

Brain InjuriesBrain Injuries, TraumaticIntracranial HypertensionGlasgow Coma ScaleHumansIntracranial PressureMonitoring, Physiologic

Identifiers

PMID37171175
PMCPMC10319366
OpenAlexW4376223901

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.