Analysis of Normal High-Frequency Intracranial Pressure Values and Treatment Threshold in Neurocritical Care Patients: Insights into Normal Values and a Potential Treatment Threshold.

JAMA Neurology
Gregory W J HawrylukGeoffrey T Manley

Abstract

Intracranial pressure (ICP) elevation is a compartment syndrome that impairs blood flow to the brain. Despite the importance of ICP values in neurocritical care, normal ICP values and the precise ICP threshold at which treatment should be initiated remain uncertain. To refine our understanding of normal ICP values and determine the ICP threshold most strongly associated with outcome. Prospective observational study (2004-2010), with outcomes determined at hospital discharge. The study included neurocritical care patients from a single level I trauma center, San Francisco General Hospital. Three hundred eighty-three patients had a traumatic brain injury with or without craniectomy; 140 patients had another indication for ICP monitoring. Consecutive patients were studied. Data analyses were completed between March 2015 and December 2019. Five hundred twenty-three ICP-monitored patients. A computer system prospectively and automatically collected 1-minute physiologic data from patients in the intensive care unit during a 6-year period. Mean ICP was calculated, as was the proportion of ICP values greater than thresholds from 1 to 80 mm Hg in 1-mm Hg increments. The association between these measures and outcome was explored for var...Continue Reading

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Citations

Feb 3, 2021·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·J N StrohTellen D Bennett
May 17, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Sarah Menacho, Gregory Hawryluk
Aug 28, 2021·Brain Sciences·Sérgio BrasilWellingson Silva Paiva

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