Latin American Brain Injury Consortium (LABIC)

In the last 50 years, national and international collaboration for large trials worldwide has become a real need and specially for achieving better patients’ outcomes.  Concerning the acute brain pathology, the need of this collaboration was enough justified by EBIC and other organizations in order to diminish mortality and secuelae.

Background

The recent understanding of the mechanisms of brain damage and the development of specific treatments has joined up the interest of certain groups and agencies for collaborating programs.  Professionals, neurosurgeons, neurologists, neurointensivists of scientific societies from different countries go along with the development and the divulgation of the new techniques for the diagnosis and patients treatment.  The concept of a Latin American organization with the same characteristics was developed by members of the Neurocritical Care Committee (SATI) in 1998. The Argentinian foundation "Alas" supported this proposition since the beginning.

This concept was proposed and discussed in different regional meetings:

  1. South American Intensive Care Congress, Iquique, Chile .Oct 2002
  2. Latin American Neurosurgery Congress FLANC, Lima, Peru. Oct 2002
  3. APICE Congress, Trieste, Italy. Nov. 2002.
  4. Researchers meeting TBI-TAB, México DF. Nov. 2002
  5. Researchers meeting  OHSU - Argentina. Portland, EEUU. Feb 2003
  6. Ibero American Congress on Critical Medicine and Intensive Care , Cancún, México, Junio 2003
  7. IIIrd International Neurocritical Care Congress, Santa Clara, Cuba, September  2003
  8. International Symposium on Neuroemergencies, Campinas, Brazil,  September 2003
  9. E-mail and phone communication

The LABIC’ s foundational meeting was held in Rosario, Argentina, October 24 – 26, 2003.  LABIC is a non-profit medical association, formed by professionals with special interest in the management of neurocritical patients.

Objectives:

  1. To promote the qualification of professionals involved in the attention of patients with acute brain injury through the organization of courses, meeting and congresses.
  2. To promote the diffusion of the recommendations and guidelines for the management of different acute pathologies of the brain.
  3. To promote and conduct researches with the goal of improving the outcome of adults and pediatric patients with acute brain injury.
  4. To establish a close collaboration among the researching institutions and the researchers in Latin America for TBI management and other acute brain pathologies.
  5. To negotiate and participate with the sponsors of the investigations in order to ensure the excellence in design, development, analysis and publication of the different trials and researches.
  6. To act as a consultant institution in the theoretical and practical aspects of the different studies.
  7. To promote the cooperation with the rest of the Consortiums or Brain Injury Groups (regional or from other continents).

Nomination and organization

The name consortium will allow us to obtain, get support, funds from different entities in various countries.  LABIC structure is a formal one with enough capacity of being flexible and it will allow us to carry on different tasks in order to achieve the proposed objectives.

Core Data survey

The possibility of a cooperative research was tested in many Latin American centers in two studyes: ‘Pilot Study Core Data survey’ and ‘Cores Study of Centers Characteristics’.

Property of Information

The property of information will be exclusively of LABIC. The different reserachers can ask for the information from the different databases that will be created for that end. The publication of such information in an article, table or other format such as journals, congresses, web sites will be made by the proposal of the researchers after approval of the Executive Committee of LABIC.

Guidelines for the acute brain pathologies

In the last years, different guidelines for the acute brain pathology have been developed, specially the ones related to TBI evidence based on consensus or experts opinion. So there is evidence that in spite of the existence of different Guidelines, there are remarkable differences in TBI management in different centers of the same region or country.

Clinical Trials

The evaluation of potential clinical trials and other pathologies will be carried out among, first, LABIC members and among the latter and other agencies and laboratory representatives in order to evaluate the potential “clinical trials”.

Communicación and information

The communication and cooperation with members from Oregon University has been an important support and encouragement for the creation of LABIC. These contacts have been sustainable during the last years through Congresses attendance and through the participations in research on TBI rehabilitation (Traumatic Brain Injury: The Argentina Project).

The communication and cooperation with EBIC has started previously to LABIC and regular contacts have been maintained with different members of the European Consortium. This allowed us to participate in some EBIC studies (…Mass lesion…, 2000-2001), the arrangement of research projects with the participation of EBIC members (Different levels of critical care in moderate and severe Traumatic Brain Injury patients) and the constant support and encouragement for the creation of LABIC. 

The future

The level of activity and influence will be achieved according to the commitment through the network built by the investigators from the different centers in Latin America. We believe that this point, the commitment and belief in LABIC, could build an institution as a useful tool and solid basis over which future activities will be developed. Another important aspect, but not fundamental, is  the  economic and financial resources to which we may have access but this, beyond our efforts, will depend on many variables related to different policies in different and heterogenous Latin American countries that are characterized by the irregularity and constant  political, health, education and research changes.  

Acknowledgments

To Randall  M. Chesnut M.D., for his constant encouragement since 1998 for LABIC creation. To  Nancy Carney Ph. D., for her constant support  and representatio in the U.S.A. To N. Stocchetti M.D., for his participation in the design and development of the first studies. To Franco Servadei, M.D. who since 2000 supports the LABIC achievement and his approach and participation in EBIC studies.

                              
References

  1. The European Brain Injury Consortium. Teasdale GM, Braakman R, Cohadon F, Dearden M, Iannotti F, Karimi A, Lapierre F, Maas A, Murray G, Persson L, Servadei F, Stocchetti N, Trojanowski T, Unterberg A. Acta Neurochir (Wien) 1997;139:797-803.
  2. Maas AI, Dearden M, Teasdale GM, Brakman R, Cohadon F, Iannotti F, Karimi A, Lapierre F, Murray G, Ohman j, Persen L, Servadei F, Stocchetti N, Unterberg A (1997) EBIC-guidelines for management of severe head injury in adults European Brain Injury Consortium Acta Neurochir (Wien) 139(4):286-294.
  3. Procaccio F, Stocchetti N, Citerio G, Berardino M, Beretta L, Della Corte F, D'Avella D, Brambilla GL, Delfini R, Servadei F, Tomei G (2000) Guidelines for the treatment of adults with severe head trauma (part II) Criteria for medical treatment J Neurosurg Sci 44(1):11-18.
  4. Procaccio F, Stocchetti N, Citerio G, Berardino M, Beretta L, Della Corte F, D'Avella D, Brambilla GL, Delfini R, Servadei F, Tomei G. (2000) Guidelines for the treatment of adults with severe head trauma (part I). Initial assessment; evaluation and pre-hospital treatment; current criteria for hospital admission; systemic and cerebral monitoring J Neurosurg Sci 44(1):1-10.
  5. Bullock R, Chesnut RM, Clifton C et al (1996) Guidelines for the Management of Severe Head Injury J Neurotrauma 13:643-734.
  6. Gabriel EJ, Ghajar J, Jagoda A, Pons PT, Scales T, Walters BC (2002) Guidelines for Prehospital Management of Traumatic Brain Injury J Neurotrauma 19(1);111-174

Appendix #1- Recquirements for become part of LABIC.

Requirements:

  1. Title of medical Doctor, given by a Latin-American University, or University Title of other discipline that accounts for special interest in the multidisciplinary work related to brain injury. ( Brief  Curriculum )
  2. Specialty related to Brain Injury ( Brief Curriculum)
  3. Latin-American survey  (Send the form to  elai_labic@fundacionalas.org.ar )
  4. To be presented by two active members or founders
  5. Directive Commission Acceptation
  6. To send the whole information to  fundacionalas@fundacionalas.org.ar, afterwards, the decision of the Directive Commission will be known and a Affiliation form will be sent to the applicant.www.fundacionalas@fundacionalas.org.ar

Appendix #1 - Organization and relates.

Organization:

  1. Directive Commission  (17 members)
    1. President: Dr. Walter Videtta, Argentina
    2. First Vice-president: Dra. Corina Puppo, Uruguay
    3. Second Vice-president: Dr. Miguel F. Arango, Colombia
    4. First Secretary: Dr. Gustavo Petroni, Argentina
    5. Second Secretary,  Treasurer and pro-treasurer
    6. Vocals (10)
  2. Fiscal Commission (4 members)
  3. Directive commission meetings every six months
  4. Plenary Meeting every year
  1.  
    1. Founders : Those who subscribed the foundational act.
    2. Active members: Those with a Latin-American University qualification, and with a specialty related with brain injury. The active member should be presented by two active members and/or founders and accepted by the Directive Commission.
    3. Adherent members: Those non doctors who demonstrate special interest with the interdisciplinary work related to brain injury, and are graduated at the University. They should be presented by two active members and/or founders and accepted by the Directive Commission 
    4. Honorary members: Those who have special and recognized personal and scientifical conditions , and because of the services to the association are proposed by the Directive Commission  or  the 20% of the members who can vote and approved by the whole assembly.

 

Appendix #1

Investigator

Centrer

Country

     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     

Trashes

American Brain Injury Consortium

Founded in Richmond Virginia, in April, 1993 by an outstanding group of neurosurgeons for improving the outcome of brain injured patients, through the scientifical researches.

European Brain Injury Consortium

Founded in May, 1995, by neurosurgeons and neurointensivists. The coordinator centre is the University of Glasgow and the main goal is to obtain a better outcome for the brain injured patients, through collaborative and well designed researches

Research Projects

  1. Latin American Survey in Intensive Care Activity (Core data survey).
  2. Different levels of critical care in moderate and severe TBI patients.
  3. Treatment of pediatric TBI (Pediatric Guidelines).

 

Walter Videtta, MD
ICU Neurocritical Care
Hospital Nacional 'Prof. a. Posadas'
El Palomar - Pcia. de Buenos Aires - Argentina
President

Corina Puppo, MD 
Assistant professor, Intensive Care Unit, Clinics Hospital, Universidad de la República, Uruguay 
Vicepresident, LABIC

Gustavo Petroni, MD Secretary, LABIC

Renato G. Terzi, MD, Professor 
Founder Member, LABIC

Carlos Rondina, MD 
Founder Member, LABIC

Silvia Lujan, MD 
Member, LABIC