Avoidance of hypotension: Conditio sine qua non of successful severe head-injury management
Avoidance of hypotension: Conditio sine qua non of successful severe head-injury management
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DOI：
10.1097/00005373-199705001-00002
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发表时间：
1997-05-01
影响因子：
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通讯作者：
Chesnut, RM
中科院分区：
文献类型：
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作者：
Chesnut, RM
临床医学实践的特点是基于临床报告、实验室调查和轶事经验的结合。不幸的是，在决定管理策略时，还没有一个明确的科学有效性等级来指导医生权衡这些不同的因素。对于严重的头部损伤，这导致了文献记载的临床治疗方法的广泛差异，在某种程度上，在某些情况下，患者可能使用已被证明肯定无效的药物治疗，同时缺乏应用极有可能有用的策略此外，为了保持和促进治疗的前沿，学术中心倾向于专注于开发新的和不断发展的治疗策略，而不是更繁琐但非常必要的工作，即经验地确定我们目前的管理课程的哪些方面实际上是有效的。因此，在1996年，我们对自由基抑制在决定创伤性脑损伤（TBI）预后方面的作用比脑灌注压管理了解得更多。
The practice of clinical medicine is characteristically based on a combination of clinical reports, laboratory investigations, and anecdotal experience. Unfortunately, a clear hierarchy of scientific validity has not been developed to guide the physician in weighting these various factors when deciding on a management strategy. With respect to severe head injury, this has resulted in a wide variation in documented clinical management approaches to the extent that, in some cases, patients may be treated with agents that have been shown to definitely be ineffective concomitantly with the lack of application of strategies that have a high likelihood of being useful.[1] In addition, in the interest of maintaining and furthering the cutting edge of treatment, academic centers tend to focus on developing new and evolving strategies for treatment rather than the more tedious but highly necessary job of empirically determining what aspects of our present courses of management are actually effective. Therefore, in 1996, we know more about the efficacy of free-radical inhibition than cerebral perfusion pressure management in determining outcome from traumatic brain injury (TBI).