Table 1.
Treatment NOT recommended for use in the management of severe traumatic brain injury (when both ICP and PbtO2 are monitored)
| Mannitol by non-bolus continuous intravenous infusion |
| Scheduled infusion of hyperosmolar therapy (e.g., every 4–6 h) |
| Lumbar CSF drainage |
| Furosemide |
| Routine use of steroids |
| Routine use of therapeutic hypothermia to temperatures below 35 °C due to systemic complications |
| High-dose propofol to attempt burst suppression |
| Decreasing PaCO2 below 30 mmHg/4.0 kPa |
| Routinely raising CPP above 90 mmHg |
| Barbiturates as treatment for low PbtO2 unless barbiturates are otherwise indicated |
| Hypothermia as treatment for low PbtO2 unless hypothermia is otherwise indicated |
| Hypercarbia in “type D” patients |
CPP cerebral perfusion pressure, ICP intracranial pressure, kPa kiloPascals, PaCO2 arterial partial pressure of carbon dioxide, PbtO2 brain tissue partial pressure of oxygen