The objective of this application is to establish a network of Centers of Excellence within the Latin American Brain Injury Consortium (LABIC) that will, in collaboration with U.S. partners, conduct research and training programs about traumatic brain injury (TBI).
Our specific aims are: #1: In a randomized controlled trial in 3 trauma centers in Bolivia, test the effect on outcomes of management of severe TBI guided by information from ICP monitors vs. a standard empiric protocol. #2: In a prospective, observational study in 7 trauma centers in Latin America, test the association between resource availability/medical management and outcomes for patients with severe TBI. #3: Establish a network of research centers with investigators trained and skilled in the design, conduct, and funding of research programs to address TBI and other brain disorders in Latin America. We hypothesize that: #1. Patients with severe TBI whose acute care treatment is managed using ICP monitors will have significantly lower mortality and better neuropsychological and functional recovery at 6 months post-trauma than those whose treatment is managed with the standard protocol. #2. The incorporation of ICP monitoring into the care of patients with severe TBI will minimize secondary complications and decrease length of stay in ICU. #3. The association between treatment and outcomes for patients with severe TBI identified in the randomized trial of ICP monitoring will generalize to the population in the prospective, observational, study. #4. Variations in resource availability and medical management will be significantly associated with mortality and functional recovery for patients with severe TBI, after controlling for patient and injury characteristics. In fulfilling the aims of this project, important research questions will be answered about TBI in an environment of limited resources, aspects of which will generalize to other developing countries as well as to the developed world. Sustainable capacity to conduct research about TBI in Latin America will be established. Within the structure of LABIC, a cadre of professionals will be trained in clinical research who will be equipped to carry out studies that answer questions which are relevant and important to Latin America. These studies will establish a literature base from which Latin American investigators can generate their own guidelines for the treatment of TBI.

National Institute of Health (NIH)
National Institute of Neurological Disorders and Stroke (NINDS)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-ICP2-B (50))
Program Officer
Hicks, Ramona R
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Washington
Schools of Medicine
United States
Zip Code
Bonow, Robert H; Barber, Jason; Temkin, Nancy R et al. (2018) The Outcome of Severe Traumatic Brain Injury in Latin America. World Neurosurg 111:e82-e90
Heaton, Robert K; Akshoomoff, Natacha; Tulsky, David et al. (2014) Reliability and validity of composite scores from the NIH Toolbox Cognition Battery in adults. J Int Neuropsychol Soc 20:588-98
Dikmen, Sureyya S; Bauer, Patricia J; Weintraub, Sandra et al. (2014) Measuring episodic memory across the lifespan: NIH Toolbox Picture Sequence Memory Test. J Int Neuropsychol Soc 20:611-9
Weintraub, Sandra; Dikmen, Sureyya S; Heaton, Robert K et al. (2013) Cognition assessment using the NIH Toolbox. Neurology 80:S54-64
Chesnut, Randall M; Petroni, Gustavo; Rondina, Carlos (2013) Intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 368:1751-2
Chesnut, Randall M (2013) Intracranial pressure monitoring: headstone or a new head start. The BEST TRIP trial in perspective. Intensive Care Med 39:771-4
Chesnut, Randall M; Temkin, Nancy; Carney, Nancy et al. (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:2471-81
Carney, Nancy; Lujan, Silvia; Dikmen, Sureyya et al. (2012) Intracranial pressure monitoring in severe traumatic brain injury in latin america: process and methods for a multi-center randomized controlled trial. J Neurotrauma 29:2022-9
Chesnut, Randall M; Temkin, Nancy; Carney, Nancy et al. (2012) Traumatic brain injury in Latin America: lifespan analysis randomized control trial protocol*. Neurosurgery 71:1055-63
Petroni, Gustavo; Quaglino, Marta; Lujan, Silvia et al. (2010) Early prognosis of severe traumatic brain injury in an urban argentinian trauma center. J Trauma 68:564-70