The Lund Therapy: A Physiological Approach

In principle, most guidelines for treatment of severe traumatic brain oedema (TBI), such as the Brain Trauma Foundation (US) guidelines, are based on a meta-analytic approach. The alternative that the guideline in its main parts is based on basal physiological haemodynamic principles for brain volume control and brain perfusion, forms the principles for the Lund concept. As the Lund concept (LC) is the only guideline based on basal physiological haemodynamic principles, it has been given a separate chapter in this book. Important principles of the Lund concept consider mechanisms controlling transcapillary exchange in the brain with disrupted blood-brain barrier (BBB) and the importance of preserving normovolaemia and brain perfusion. The LC finds support from several smaller studies, but, like for other guidelines available today, we lack a randomized study of its effectiveness to improve outcome.