Please note this episode was recorded in November 2018 as part of Brain, a CICM Neuro Special Interest Group meeting click here for more info.
Oli Flower gives us a preview into the future of traumatic brain injury (TBI) management. It is late in the 21st century and a man suffers a TBI. Oli describes the on scene immediate management of this patient. Drones and closed-circuit cameras combine to provide the closest ever trauma centre, taking tissue samples and patient images. Not only that, but the samples have been analysed and referenced against a huge database, providing the awaiting critical care clinicians with an individualised and effective treatment plan for each patient.
But, this future depends on information.
To develop the technology that Oli envisages, we need to collect more information in the right way. Ultimately, the future of TBI management requires the development of tools to apply masses of information to the patient in a meaningful way.
One such was to achieve this, is by using biobanks. A biobank is a repository of human tissues and samples with the corresponding appropriate and correct annotating data. Specifically, for TBI this primarily means blood and CSF. The tissue is annotated with prognostic information and patient centred long-term outcome data from its donor, allowing a huge pool of information that can be accessed to inform treatment moving forward.
Evidently, the potential for a biobank is enormous. Oli describes rapid genomic assessment, proteomic analysis and metabolomic profiling as potentials in the near future. This data would provide a plethora of information per patient. This does however, pose a challenge, and leads to the need for advanced computer processing to interpret the data, whilst being able to factor in the dynamic and evolving processes that define critical care. Artificial intelligence no doubt has a part to play.
Biobanks have started to be developed across Australia and the world. However, they requires a massive collaboration that spans across countries. In doing so, we can strive towards the future treatment of TBI.
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