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Critical Care

Open Access

The RESCUEicp decompressive craniectomy trial

  • P Hutchinson1,
  • I Timofeev1,
  • S Grainger1 and
  • E Corteen1
Critical Care200913(Suppl 1):P85

Published: 13 March 2009


Traumatic Brain InjuryMedical ManagementIntracranial PressureBarbiturateMain Study


The RESCUEicp study (Randomised Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of Intracranial Pressure) aims to provide Class 1 randomised evidence as to whether decompressive craniectomy is effective for the management of patients with raised and refractory intracranial pressure (ICP) following traumatic brain injury.


An international multicentre randomised trial comparing decompressive craniectomy with medical management. Patients (n = 50 for the pilot phase, n = 600 for the main study) with traumatic brain injury and raised ICP (>25 mmHg) refractory to initial treatment measures are eligible for the study. Patients are randomised to one of two arms: continuation of optimal medical management (including barbiturates) versus surgery (decompressive craniectomy). The inclusion criteria are: traumatic brain injury, age 10 to 65 years, abnormal CT scan and the exclusion criteria: bilateral fixed and dilated pupils, bleeding diathesis, devastating injury not expected to survive 24 hours. Outcome is assessed using the extended Glasgow Outcome Score and the SF-36 quality of life questionnaire at 6 months, 1 year and 2 years. See Figure 1.
Figure 1



Over 170 patients have been recruited to date. At present we have achieved 97% data collection and 94% follow up. The study is ongoing.


Randomising patients with traumatic brain injury to decompressive craniectomy versus optimal medical management is feasible. Whether the operation is effective and safe remains to be seen. We would welcome more centers' participation.

Authors’ Affiliations

University of Cambridge, UK


  1. Timofeev I, Hutchinson PJ: Outcome after surgical decompression of severe traumatic brain injury. Injury 2006, 37: 1125-1132. 10.1016/j.injury.2006.07.031View ArticleGoogle Scholar
  2. Winter CD, et al.: The role of decompressive craniectomy in the management of traumatic brain injury: a critical review. J Clin Neurosci 2005, 12: 619-623. 10.1016/j.jocn.2005.02.002View ArticleGoogle Scholar


© Hutchinson et al; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.