Guidelines for the Treatment of Severe Traumatic Brain Injury

PACIFIC COAST SURGICAL ASSOCIATION Guidelines for the Treatment of Severe Traumatic Brain Injury: Are They Used? Persons with severe traumatic brain injury (STBI) are frequently admitted to the neurologic intensive care unit. Each year, an estimated 1.4 million people in the United States have a TBI, resulting in 235 000 hospitalizations, 50 000 deaths, and $56.3 million in direct/indirect costs. Evidence-based guidelines for the management of patients with STBI have been available from the Brain Trauma Foundation (BTF) since 1995.1 Current recommendations, particularly those related to intracranial pressure (ICP),1 remain controversial owing to the questions raised by single-center studies and international trials about the benefit2-4 and feasibility5 of implementation. Based on a national assessment of US trauma medical directors (TMDs), the objective of our study was to determine the extent to which BTF guidelines are used.