Intracranial pressure monitoring in severe traumatic brain injury - Results of a Canadian survey

Objective: The purpose of this study was to obtain information from Canadia n neurosurgeons regarding their opinions on, and utilization of, intracrani al pressure (ICP) monitoring for severe traumatic brain injury (TBT). Metho ds: A brief survey was sent to practicing Canadian neurosurgeons questionin g them about their utilization of, and confidence in, intracranial pressure monitoring in the management of patients with severe TBI. Results: One hun dred and ninety-six surveys were mailed. There were 103 responses for a res ponse rate of 52.6%. The vast majority of responding neurosurgeons (98.1%) utilized ICP monitoring in the management of patients with severe TB I, wit h most (63.4%) using it in more than 75% of their patients, 14.9% using it in 50-75% of patients, 14.9% in 25-50% of patients, and 6.9% using it in le ss than 25% of patients. The level of confidence that routine monitoring im proves outcome from severe TBI ranged from 23.3% having a low level of conf idence, 56,3% having an intermediate level of confidence, to 20.4% having a high level of confidence. Most respondents (78.6%) felt that some form of prospective trial evaluating the role of ICP monitoring in improving outcom e from severe TBI was warranted; 17.4% felt such a trial was not warranted and 3.9% were uncertain. Conclusions: While ICP monitoring has gained almos t universal acceptance among responding Canadian neurosurgeons, their level of confidence that routine monitoring improves outcome from severe TBI was quite variable, with only 20.4% of respondents having a high level of conf idence. Over 75% of respondents felt that some form of prospective trial ev aluating the utility of ICP monitoring is warranted. This information is be ing used in consideration of a prospective trial addressing this issue.