Intracranial pressure monitoring in the ICU

2016 ◽  
Author(s):  
Jonathan K. J. Rhodes ◽  
Peter J. D. Andrews
Keyword(s):  
Brain Injury ◽  
Intracranial Pressure ◽  
Perfusion Pressure ◽  
South American ◽  
Pressure Monitoring ◽  
Recent Trial ◽  
Computed Tomographic ◽  
The Central Nervous System ◽  
Monitoring Modality ◽  
The Impact

Intracranial pressure (ICP) measurement is an established monitoring modality in the ICU and can aid prognostication after acute brain injury. ICP monitoring is recommended in all patients with severe traumatic brain injury (TBI), and an abnormal cranial computed tomographic (CT) scan and the ability to control ICP is associated with improved outcome after TBI. The lessons from TBI studies can also be applied to other acute pathologies of the central nervous system where ICP can be increased. ICP measurement can warn of impending disaster and allow intervention. Furthermore, measurement of ICP allows the calculation of cerebral perfusion pressure (CPP) and maintenance of CPP may help to ensure adequate cerebral oxygen delivery. Various systems exist to monitor ICP. A recent trial in two South American countries suggested that ICP-guided management and management guided by clinical examination and repeated imaging produced equivalent outcomes. Although this trial currently provides the best evidence regarding the impact of monitoring ICP on outcome following TBI, but because of the inadequate power and questionable external validity, the generalizability of the results remain to be confirmed.

scholarly journals Study of Intracranial Pressure Monitoring In Traumatic Brain Injury

2018 ◽  
Vol 15 (2) ◽  
pp. 23-29
Author(s):  
Nilam Khadka ◽  
Rajan Kumar Sharma ◽  
Rajiv Jha ◽  
Prakash Bista
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Fiber Optic ◽  
Standard Of Care ◽  
Intracranial Pressure Monitoring ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Serious Adverse Events ◽  
Monitoring Modality

Intracranial pressure monitoring is considered the standard of care for severe traumatic brain injury and is used frequently. However, the efficacy of treatment based on monitoring in improving the outcome has not been rigorously assessed. We conducted a trial in which we included 26 patients of all types of traumatic brain injury (TBI) and they were monitored for intracranial pressure by Conventional fluid filled system with a manometer (Group 1) and compared with the Fiber optic transducer-tipped intracranial pressure monitoring system (Group 2).The main aim of this study was to examine the relationship between Intracranial Pressure (ICP) monitoring and in-hospital mortality. The median length of stay in the ICU was similar in the two groups (12 days in the conventional pressure-monitoring group and 9 days in the new fiber optic group; P=0.25), the number of days of brain-specific treatments (e.g., administration of hyperosmolar fluids and the use of hyperventilation) in the ICU was similar in both groups. The distribution of serious adverse events was similar in the two groups. We concluded that ICP monitoring (as is any monitoring modality) is a useful guide for management. The outcomes are decided by the differences in management protocols that the knowledge of the said parameter brings about. ICP monitoring is recommended for the better management of traumatic brain injury and fiber optic ICP monitoring seems to be beneficial than using the conventional methods of ICP monitoring with manometer.Nepal Journal of Neuroscience, Volume 15, Number 2, 2018, page: 23-29

Central Nervous System Injury

2017 ◽  
Author(s):  
Brandon R Bruns ◽  
Deborah M Stein
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Perfusion Pressure ◽  
Intracranial Pressure Monitoring ◽  
Pressure Monitoring ◽  
Cerebral Contusion ◽  
Different Types ◽  
Hospital Visits

Traumatic brain injury (TBI) accounts for 2.5 million hospital visits annually and is the leading cause of death and disability in patients age 1 to 44 years. Evaluation of patients with suspected TBI requires prompt physical examination with a focus on calculation of the Glasgow Coma Score and pupillary examination as early treatments can be initiated at this stage in patient management. Diagnostic studies include basic laboratory parameters and prompt evaluation with brain computed tomography to identify space-occupying lesions (blood) within the rigid calvarium. Distinction between the different types of traumatic intracerebral hemorrhage is imperative and enables prompt neurosurgical consultation, as well as initiation of appropriate medical therapies to treat elevated intracranial pressure and maintain cerebral perfusion pressure. Paramount in managing patients with suspected TBI is the avoidance of hypotension and hypoxia. Intracranial pressure monitoring remains controversial but is a cornerstone in TBI management. Patients with TBI may have lifelong complications and require careful follow-up. Many new prognostic tools are currently available. This review contains 4 figures, 4 tables, and 47 references. Key words: cerebral contusion, epidural hematoma, intracranial pressure monitoring, subdural hematoma, traumatic brain injury 

The impact of intracranial pressure monitoring on mortality after severe traumatic brain injury

2015 ◽  
Vol 210 (6) ◽  
pp. 1082-1087 ◽  
Author(s):  
Brian W. MacLaughlin ◽  
David S. Plurad ◽  
William Sheppard ◽  
Scott Bricker ◽  
Fred Bongard ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Severe Traumatic Brain Injury ◽  
Intracranial Pressure Monitoring ◽  
Pressure Monitoring ◽  
The Impact

In Reply to “Intracranial Pressure Monitoring in Traumatic Brain Injury”

2017 ◽  
Vol 100 ◽  
pp. 704-705
Author(s):  
Hosseinali Khalili ◽  
Nazanin Sadraei ◽  
Amin Niakan ◽  
Fariborz Ghaffarpasand ◽  
Amin Sadraei
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Intracranial Pressure Monitoring ◽  
Pressure Monitoring
Sign in / Sign up

Export Citation Format

Share Document