Neuroanesthesia & neurocritical care
Review Paper on Penetrating Brain Injury: Ethical Quandaries in the Trauma Bay and Beyond
Authors' conclusion
Support of the patient after multicavitary PBI can be complex and is best addressed in a multidisciplinary fashion with extensive community involvement.
Study context
- Population
- Patients presenting with penetrating brain injury (PBI) and multicavitary trauma
Methodological detailsmultidisciplinary expert opinion, guideline-informed, Review of recent multidisciplinary evidence-informed guidelines for PBI combined with expert opinion from trauma, neurosurgery, neurocritical care, pediatric and transplant surgery, surgical ethics and community partners
- Multidisciplinary expert opinion
- Guideline-informed
- Review of recent multidisciplinary evidence-informed guidelines for PBI combined with expert opinion from trauma, neurosurgery, neurocritical care, pediatric and transplant surgery, surgical ethics and community partners
Recommendations
As reported in the abstract
- Traditional TBI prognostic signs may not be applicable to PBI; multidisciplinary team approach suggested case by case
- Even with no role for neurosurgical intervention, neurocritical care and neurointerventional support may be warranted, in parallel to multicavitary operative intervention
- Special considerations for pediatric PBI
- Ethical considerations center on providing the best chance of survival; organ donation considered as part of patient, proxy and family-centric support
- Community input crucial in guiding decision making or institutional protocols
Original publication
Review Paper on Penetrating Brain Injury: Ethical Quandaries in the Trauma Bay and Beyond. Ann Surg. Published 23 August 2022. doi:10.
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