Neuroanaesthesia & neurocritical care
Concordance Between Bedside and Electronic Detection of Intracranial Pressure Crises: Insights From the Brain Tissue Oxygen Monitoring and Management in Severe Traumatic Brain Injury II Trial
Authors' conclusion
Our findings suggest that current methods of clinical identification of B-ICP episodes may not reliably distinguish true episodes of sustained ICP for the most common B-ICP episode type.
Study context
- Population
- Severe traumatic brain injury (TBI) patients in the BOOST II trial, 10 US ICUs; minimalist bedside ICP (B-ICP) episodes (≤60 minutes, tier 1 treatments only)70 of 110 randomized patients
- Participants
- 241 vs 286
- Comparison
- Bedside intracranial pressure (ICP) crisis identification vs background-collected electronic ICP
- Concordantn = 241
- Discordantn = 286
Methodological detailspost hoc, multicentre, Insufficient data to evaluate temporal asynchrony between BC and electronic datapoints, Limitations: no rigid end-of-B-ICP episode definition; inability to fully control for temporal synchrony confounding
- Post hoc
- Multicentre
- Insufficient data to evaluate temporal asynchrony between BC and electronic datapoints
- Limitations: no rigid end-of-B-ICP episode definition; inability to fully control for temporal synchrony confounding
Primary result
As reported in the abstract
Minimalist B-ICP episodes confirmed by E-ICP 5
- Minimalist B-ICP episodes identified and treated by bedside clinicians
- 509
- Confirmed by electronic ICP (E-ICP) 5
- 47%
- Concordant episodes with E-ICP AVG <20 mm Hg
- 38%
- Discordant episodes with E-ICP AVG <20 mm Hg
- 76%
- Discordant episodes with both E-ICP AVG and E-ICP MAX <20 mm Hg
- 31%
Further findings
Confounding (brief, first, or easily controlled episodes)
- Testing for confounding did not provide explanations
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Concordance Between Bedside and Electronic Detection of Intracranial Pressure Crises: Insights From the Brain Tissue Oxygen Monitoring and Management in Severe Traumatic Brain Injury II Trial. Crit Care Med. Published 18 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →