Extracranial Tsunami After Traumatic Brain Injury

The primary goal of the intensive care management of patients with traumatic brain injury (TBI) is to prevent and treat secondary brain injury by maintaining adequate oxygen delivery and cerebral perfusion pressure. However, non-neurological organ dysfunctions are common after TBI and are an independent factor—but potentially amenable to treatment—related to morbidity and mortality. There is a wide range of systemic complications following TBI. Among these, respiratory, cardiovascular, renal, and liver failure as well as involvement of the hematological system are the most common and can influence early management, mortality, and morbidity. Therefore, prompt recognition, prevention, and treatment of systemic complications represent a modifiable risk after TBI with a potentially important effect on the outcome. In this chapter, we focus on recent evidence on the incidence, features, and treatment of TBI-related complications of systemic organs. Targeted therapy to optimize systemic function may reduce mortality and may improve outcome in TBI survivors.