After severe traumatic brain injury, adequate blood flow to the brain is essential for recovery. This depends on arterial blood pressure, yet intensive care units apply fixed targets to all patients - treating every brain and patient the same. This study aims to change that. With new technology, 'optimal' blood pressure can be determined for each individual brain and treatment can be tailored accordingly. This personalized approach to neurocritical care has never been tested in a randomized controlled study before. If effective in showing reduced brain damage biomarkers, it will fundamentally transform brain injury treatment and dramatically improve recovery outcomes for patients worldwide.
Adult (>18 years old)
Severe TBI requiring ICP-directed therapy for at least 24 hrs on the assessment of the recruiting intensive care team and/or attending neurosurgeon
Start randomization within 24 hrs after ICU admission.
Known pregnancy
Moribund at presentation (e.g. bilaterally absent pupillary responses)
Patients with a primary decompressive craniectomy
Failure to get final written informed consent
Maastricht University Medical Center
Lead sponsor
Medisch Spectrum Twente
Collaborator
Radboud University Medical Center
Collaborator
Medical Center Haaglanden
Collaborator