Cerebrovascular Autoregulation Monitoring in the Management of Adult Severe Traumatic Brain Injury: A Delphi Consensus of Clinicians

• DOI: 10.1007/s12028-020-01185-x
• Publication Date: 2021-01-25T19:05:01Z
• Authors: B. Depreitere; G. Citerio; M. Smith; P. David Adelson; M. J. Aries; T. P. Bleck; P. Bouzat; R. Chesnut; V. De Sloovere; M. Diringer; J. Dureanteau; A. Ercole; G. Hawryluk; C. Hawthorne; R. Helbok; S. P. Klein; J. O. Neumann; C. Robba; L. Steiner; N. Stocchetti; F. S. Taccone; A. Valadka; S. Wolf; F. A. Zeiler; G. Meyfroidt
• Keywords: Delphi Method; Cerebral autoregulation; Delphi

Several methods have been proposed to measure cerebrovascular autoregulation (CA) in traumatic brain injury (TBI), but the lack of a gold standard and absence prospective clinical data on risks, impact care outcomes implementation CA-guided management lead uncertainty.To formulate statements using Delphi consensus approach employing group expert clinicians, that reflect current knowledge CA, aspects can be implemented TBI CA research priorities.A 25 international academic experts with expertise adult severe patients participated this process. Seventy-seven multiple-choice questions were submitted two online surveys, followed by face-to-face meeting third survey. Participants received feedback average scores rationale for resubmission or rephrasing statements. Consensus statement was defined as agreement more than 75% participants.Consensus amongst participants achieved importance status pathophysiology, dynamic non-binary nature impairment, its association outcome inadvisability universal absolute cerebral perfusion pressure targets. could not reached accuracy, reliability validation any assessment method. There also no how implement information protocols, reflecting insufficient evidence.The process resulted addressing pathophysiology impaired targets outcome. A agenda emphasizing need better validated well focused investigation application safety, feasibility efficacy studies.