[Recommendations for time-limited trial in neurocritical care].

IF 1 Die Anaesthesiologie Pub Date : 2025-04-01 Epub Date: 2025-03-17 DOI:10.1007/s00101-025-01516-7
Angelika Alonso, Annette Rogge, Patrick Schramm, Urs Münch, Susanne Jöbges
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Abstract

Many acute brain disorders are associated with acute disorders of consciousness. In an emergency situation, life-saving measures are usually taken first and intensive care is initiated. If there is no significant improvement with recovery of consciousness in the first few days, very complex decision-making situations arise regularly. In neurointensive care, a time-limited therapy trial (TLT) is an important structuring element in treatment planning and communication, as a binding agreement between the treatment team and the patient or legal representative on a treatment concept for a defined period of time. Due to the prolonged neurological rehabilitation phase, the TLT in neurointensive care can also last weeks or months. This often requires interdepartmental communication (acute/rehabilitation/long-term care), re-evaluation and implementation in neurointensive care. The recommendations include the definition, empirical evidence and implementation suggestions for a TLT for critically ill neurointensive care patients.

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[在神经危重症护理中有时限试验的建议]。
许多急性脑障碍与急性意识障碍有关。在紧急情况下,通常首先采取挽救生命的措施,然后开始重症监护。如果在最初的几天里意识恢复没有明显的改善,就会经常出现非常复杂的决策情况。在神经重症监护中,限时治疗试验(time-limited therapy trial, TLT)是治疗计划和沟通的重要组成部分,是治疗团队与患者或法定代表在一定时间内就治疗理念达成的具有约束力的协议。由于神经康复阶段延长,神经重症监护的TLT也可能持续数周或数月。这通常需要跨部门沟通(急性/康复/长期护理),重新评估和实施神经重症监护。建议包括神经重症患者TLT的定义、经验证据和实施建议。
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