Since without prospective randomized studies it is not possible to have a
clear attitude towards the importance of intracranial pressure monitoring,
this study was aimed at examining the prognostic effect of the intracranial
pressure monitoring and intracranial pressure oriented therapy in severe
brain trauma patients, and at defining optimal intracranial pressure values
for starting the treatment. Two groups of patients were treated in the study,
one consisted of 32 patients undergoing intracranial pressure monitoring and
the second group of 29 patients without intracranial pressure monitoring in
the control group. The study was prospective with groups randomized. There
were 53% survivals in the intracranial pressure monitored patients and 34% in
the control group, with no significant difference in the survival rate
between the two groups (?2=2.11; p=0.15; p>0.05). The average intracranial
pressure in the patients with intracranial hypertension who died was 27 mm
Hg, while in the patients who survived the average intracranial pressure was
significantly lower (Student?s t test: t=2.91; p=0.008; p<0.01) and it was 18
mm Hg. We recommend starting intracranial pressure oriented therapy when the
patient?s intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.
Hypothermia for the Management of Intracranial Hypertension in Severe Brain Trauma: The Paradigm is Broken?
