Management of severe traumatic brain injury in regions with limited resources

Importance: Severe traumatic brain injury (sTBI) is a critical health problem in regions of limited resources (RLRs). Younger populations are among the most impacted. The objective of this review is to analyze recent consensus-based algorithms, protocols and guidelines proposed for the care of patients with TBI in RLRs. Observations: The principal mechanisms for sTBI in RLRs are road traffic injuries (RTIs) and violence. Limitations of care include suboptimal or non-existent pre-hospital care, overburdened emergency services, lack of trained human resources, and surgical and intensive care. Low-cost neuromonitoring systems are currently in testing, and formal neurotrauma registries are forming to evaluate both long-term outcomes and best practices at every level of care from hospital transport to the emergency department (ED), to the operating room and intensive care unit (ICU). Conclusions and Relevance: The burden of sTBI is highest in RLRs. As working-age adults are the predominantly affected age-group, an increase in disability-adjusted life years (DALYs) generates a loss of economic growth in regions where economic growth is needed most. Four multi-institutional collaborations between high-income countries (HICs) and LMICs have developed evidence and consensus-based documents focused on capacity building for sTBI care as a means of addressing this substantial burden of disease.

• Autores: Griswold, Dylan Paul; Jibaja, Manuel; Rabinstein, Alejandro A.; Godoy, Daniel Agustín; Rubiano, Andrés Mariano
• Tipo de recurso: Article of journal
• Fecha de publicación: 2021
• Institución: Universidad El Bosque
• Repositorio: Repositorio U. El Bosque
• Idioma: eng
• OAI Identifier: oai:repositorio.unbosque.edu.co:20.500.12495/9279
• Acceso en línea: http://hdl.handle.net/20.500.12495/9279; https://doi.org/10.1080/02699052.2021.1972149
• Palabra clave: Lesión cerebral traumática; PIBM; Directrices; Neurotrauma; Protocolos; Traumatic brain injury; LMICs; Guidelines; Neurotrauma; Protocols
• Rights: closedAccess
• License: http://purl.org/coar/access_right/c_14cb