Traumatic Brain Injury in Latin America: Lifespan Analysis

这项申请的目标是在拉丁美洲建立一个英才中心网络 脑损伤联盟(LABIC)，将与美国合作伙伴合作，进行研究和培训 有关创伤性脑损伤的节目。我们的具体目标是： #1：在玻利维亚3个创伤中心进行的随机对照试验中，测试 由ICP监护仪提供的信息指导的重型颅脑损伤的治疗与标准的经验性方案。 #2：在拉丁美洲7个创伤中心的前瞻性观察性研究中，测试两者之间的关联 严重脑外伤患者的资源可获得性/医疗管理和结果。 #3：建立一个研究中心网络，让研究人员在设计、实施和 资助拉丁美洲解决脑损伤和其他脑部疾病的研究项目。 我们假设：#1.重型颅脑损伤患者的急性护理治疗采用了ICP 在6岁时，监护仪的死亡率会显著降低，神经心理和功能恢复会更好 创伤后几个月，按标准方案进行治疗的患者。#2. 将颅内压监测纳入重型颅脑损伤患者的护理将最大限度减少继发性 并发症和减少在ICU的住院时间。#3.治疗与治疗结果之间的关系 在颅内压监测的随机试验中确定的重型颅脑损伤患者将推广到人群中 在前瞻性、观察性、研究性研究中。#4.资源可获得性和医疗管理的变化将 重型颅脑损伤患者控制后的死亡率和功能恢复显著相关 针对患者和受伤特征。 为了实现这个项目的目标，关于TBI的重要研究问题将在一个 资源有限的环境，其各方面将推广到其他发展中国家以及 发达国家。在拉丁美洲开展关于TBI研究的可持续能力将是 已经成立了。在LABIC的结构内，将培训一批专业人员进行临床研究 将有能力进行研究，回答与拉丁语相关和重要的问题 美国。这些研究将建立一个文献基础，拉丁美洲的研究人员可以从中产生 他们自己的治疗脑损伤的指南。

The objective of this application is to establish a network of Centers of Excellence within the Latin American Brain Injury Consortium (LABIC) that will, in collaboration with U.S. partners, conduct research and training programs about traumatic brain injury (TBI). Our specific aims are: #1: In a randomized controlled trial in 3 trauma centers in Bolivia, test the effect on outcomes of management of severe TBI guided by information from ICP monitors vs. a standard empiric protocol. #2: In a prospective, observational study in 7 trauma centers in Latin America, test the association between resource availability/medical management and outcomes for patients with severe TBI. #3: Establish a network of research centers with investigators trained and skilled in the design, conduct, and funding of research programs to address TBI and other brain disorders in Latin America. We hypothesize that: #1. Patients with severe TBI whose acute care treatment is managed using ICP monitors will have significantly lower mortality and better neuropsychological and functional recovery at 6 months post-traumathan those whose treatment is managed with the standard protocol. #2. The incorporation of ICP monitoring into the care of patients with severe TBI will minimize secondary complications and decrease length of stay in ICU. #3. The association between treatment and outcomes for patients with severe TBI identified in the randomized trial of ICP monitoring will generalize to the population in the prospective, observational, study. #4. Variations in resource availability and medical management will be significantly associated with mortality and functional recovery for patients with severe TBI, after controlling for patient and injury characteristics. In fulfilling the aims of this project, important research questions will be answered about TBI in an environment of limited resources, aspects of which will generalize to other developing countries as well as to the developed world. Sustainable capacity to conduct research about TBI in Latin America will be established. Within the structure of LABIC, a cadre of professionals will be trained in clinical research who will be equipped to carry out studies that answer questions which are relevant and important to Latin America. These studies will establish a literature base from which Latin American investigators can generate their own guidelines for the treatment of TBI.