Severe Traumatic Brain Injury Management and Clinical Outcome Using the Lund

This review covers the main principles of the Lund concept for treatment of severe traumatic brain injury. This is followed by a description of results from clinical studies in which this therapy or a modified version of the therapy has been used. Unlike other guidelines, which are based on metaanalytical approaches, important components of the Lund concept are based on physiological mechanisms for regulation of brain volume and brain perfusion and to reduce transcapillary plasma leakage and the need for plasma volume expanders. There have been 8 non-randomised and 2 randomised outcome studies with the Lund concept or modified versions of the concept. The non-randomised studies indicated that the Lund concept is beneficial for outcome. The 2 randomised studies were small but showed better outcome in the groups of patients treated according to the modified principles of the Lund concept than in the groups given a more conventional treatment.