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Clinical applications of intracranial pressure monitoring in traumatic brain injury

Stocchetti, Nino (författare)
Department of Physiopathology and Transplant, Milan University, Neuro ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
Picetti, Edoardo (författare)
Division of Anesthesia and Intensive Care, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
Berardino, Maurizio (författare)
Anesthesia and ICU, Orthopedic and Trauma Hospital, AOU Città Della Salute e Della Scienza, Turin, Italy
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Büki, Andras, 1966- (författare)
Department of Neurosurgery, University of Pécs, Clinical Neuroscience Image Center of Hungarian Academy of Sciences (HAS), Pécs, Hungary
Chesnut, Randall M. (författare)
Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States; Department of Orthopaedic Surgery, University of Washington School of Medicine, Seattle, WA, United States; University of Washington School of Global Health, Seattle, WA, United States
Fountas, Kostas N. (författare)
Department of Neurosurgery, School of Medicine, University of Thessaly, Larissa, Greece
Horn, Peter (författare)
Department of Neurosurgery, Dr. Horst Schmidt Klinik (HSK), Wiesbaden, Germany
Hutchinson, Peter J. (författare)
Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
Iaccarino, Corrado (författare)
Division of Neurotraumatology-Neurosurgery, Azienda Ospedaliero-Universitaria di Parma, ASMN-IRCCS Reggio Emilia, Parma, Reggio Emilia, Italy
Kolias, Angelos G. (författare)
Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
Koskinen, Lars-Owe (författare)
Umeå universitet,Klinisk neurovetenskap,Department of Neurosurgery, Umeå University Hospital, Umeå, Sweden
Latronico, Nicola (författare)
Department of Anesthesia and Critical Care Medicine, University of Brescia at Spedali Civili, Brescia, Italy
Maas, Andrews I. R. (författare)
Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
Payen, Jean-Francois (författare)
Pôle Anesthésie-Réanimation, CHU Grenoble, Grenoble, France
Rosenthal, Guy (författare)
Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
Sahuquillo, Juan (författare)
Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
Signoretti, Stefano (författare)
Division of Neurosurgery, Department of Head and Neck Surgery, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy
Soustiel, Jean F. (författare)
Department of Neurosurgery, Galilee Medical Center, Bar Ilan University, Naharia, Israel
Servadei, Franco (författare)
Division of Neurotraumatology-Neurosurgery, Azienda Ospedaliero-Universitaria di Parma, ASMN-IRCCS Reggio Emilia, Parma, Reggio Emilia, Italy
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 (creator_code:org_t)
2014-05-22
2014
Engelska.
Ingår i: Acta Neurochirurgica. - : Springer. - 0001-6268 .- 0942-0940. ; 156:8, s. 1615-1622
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Intracranial pressure (ICP) monitoring has been for decades a cornerstone of traumatic brain injury (TBI) management. Nevertheless, in recent years, its usefulness has been questioned in several reports. A group of neurosurgeons and neurointensivists met to openly discuss, and provide consensus on, practical applications of ICP in severe adult TBI. A consensus conference was held in Milan on October 5, 2013, putting together neurosurgeons and intensivists with recognized expertise in treatment of TBI. Four topics have been selected and addressed in pro-con presentations: 1) ICP indications in diffuse brain injury, 2) cerebral contusions, 3) secondary decompressive craniectomy (DC), and 4) after evacuation of intracranial traumatic hematomas. The participants were asked to elaborate on the existing published evidence (without a systematic review) and their personal clinical experience. Based on the presentations and discussions of the conference, some drafts were circulated among the attendants. After remarks and further contributions were collected, a final document was approved by the participants. The group made the following recommendations: 1) in comatose TBI patients, in case of normal computed tomography (CT) scan, there is no indication for ICP monitoring; 2) ICP monitoring is indicated in comatose TBI patients with cerebral contusions in whom the interruption of sedation to check neurological status is dangerous and when the clinical examination is not completely reliable. The probe should be positioned on the side of the larger contusion; 3) ICP monitoring is generally recommended following a secondary DC in order to assess the effectiveness of DC in terms of ICP control and guide further therapy; 4) ICP monitoring after evacuation of an acute supratentorial intracranial hematoma should be considered for salvageable patients at increased risk of intracranial hypertension with particular perioperative features.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

Traumatic brain injury
Intracranial pressure
Monitoring
Management

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