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PURPOSE: Uncertainties remain about the safety and efficacy of therapies for managing intracranial hypertension in acute brain injured (ABI) patients. This study aims to describe the therapeutical approaches used in ABI, with/without intracranial pressure (ICP) monitoring, among different pathologies and across different countries, and their association with six months mortality and neurological outcome. METHODS: A preplanned subanalysis of the SYNAPSE-ICU study, a multicentre, prospective, international, observational cohort study, describing the ICP treatment, graded according to Therapy Intensity Level (TIL) scale, in patients with ABI during the first week of intensive care unit (ICU) admission. RESULTS: 2320 patients were included in the analysis. The median age was 55 (I-III quartiles = 39-69) years, and 800 (34.5%) were female. During the first week from ICU admission, no-basic TIL was used in 382 (16.5%) patients, mild-moderate in 1643 (70.8%), and extreme in 295 cases (eTIL, 12.7%). Patients who received eTIL were younger (median age 49 (I-III quartiles = 35-62) vs 56 (40-69) years, p 

Original publication




Journal article


Intensive Care Med

Publication Date





50 - 61


Intracranial haemorrhage, Intracranial pressure, Subarachnoid haemorrhage, Therapy intensity level, Traumatic brain injury, Humans, Female, Middle Aged, Male, Prospective Studies, Intracranial Pressure, Intensive Care Units, Monitoring, Physiologic, Intracranial Hypertension, Brain, Brain Injuries, Traumatic, Glasgow Coma Scale