ICP management in patients suffering from traumatic brain injury: a systematic review of randomized controlled trials

  title={ICP management in patients suffering from traumatic brain injury: a systematic review of randomized controlled trials},
  author={Peter Abraham and Robert C. Rennert and Brandon C. Gabel and Jayson A. Sack and Navaz Karanjia and Peter C. Warnke and Clark C. Chen},
  journal={Acta Neurochirurgica},
BackgroundSevere traumatic brain injury (sTBI) is a major cause of morbidity and mortality. [...] Key Method We examine the available randomized controlled trial (RCT) data on the impact of ICP management on clinical outcomes after sTBI.MethodsA systematic review of the literature on ICP management following sTBI was performed to identify pertinent RCT articles.Expand
Clinical effects of intracranial pressure monitoring on traumatic craniocerebral injury prognosis
Objective: The aim of the current study was to explore the effects of intracranial pressure (ICP) monitoring on the prognosis of patients with traumatic craniocerebral injuries, providing an
Low-Value Clinical Practices In Adult Traumatic Brain Injury: An Umbrella Review
Evidence could not be considered to be strong for any clinical practice as effect measures were imprecise and heterogeneous, systematic reviews were often of low quality and most included studies had a high risk of bias.
The influence of decompressive craniectomy on intracranial pressure in patients with severe traumatic brain injury
A unilateral wide fronto-temporo-parietal craniectomy is an effective method for sustainable ICP reduction and reduces the percentage of patients with intracranial hypertension.
Management of Intracranial Pressure Part II: Nonpharmacologic Interventions
Nursing care of these patients includes perspicacious assessment and integration of data, monitoring ventilatory and hemodynamic functioning, and appropriate patient positioning to ensure favorable patient outcomes while utilizing an evidence-based guideline for the management of ICP.
Effect of combination invasive intracranial pressure (ICP) monitoring and transcranial Doppler in the treatment of severe craniocerebral injury patients with decompressive craniectomy.
The use of TCD can predict the prognosis of severe craniocerebral injury patients, and the average postoperative ICP <19 mmHg in the first 24 h, mean blood flow velocity >56.33 cm/s, end-diastolic blood flow Velocity >40.28 cm/S, and resistance index <0.57 were statistically significant indicators to predict good prognosis.
Immunomodulatory Effect of Hypertonic Saline Solution in Traumatic Brain-Injured Patients and Intracranial Hypertension
In this review, the various mechanism by which hypertonic saline exerts its immunomodulatory effects that helps in neuroprotection after TBI is summarized and understood.
Decompressive craniectomy protects against hippocampal edema and behavioral deficits at an early stage of a moderately controlled cortical impact brain injury model in adult male rats
HighlightsDC could attenuate TBI‐induced learning and memory deficits.DC could normalize MMP‐9 expression levels and reduce hippocampus edema formation after TBI.DC could stabilize expression of
Improving Post-Cardiac Arrest Cerebral Perfusion Pressure by Elevating the Head and Thorax.
Post-ROSC head and thorax elevation in a porcine model of cardiac arrest resulted in higher CerPP and lower ICP values, regardless of VF duration or CPR method.
Simultaneous Monitoring of Intracranial Pressure and Cerebral Blood Flow in Patients with Severe Brain Injury
  • A. Sirko
  • Medicine
    Archives in Neurology & Neuroscience
  • 2018
It was established that the increase of intracranial pressure leads to formation of Doppler ultrasonographic pattern of reduced perfusion, which involves relative decrease of mean linear blood flow velocity and increase of peripheral resistivity indices (pulsatility and resistsivity indices).
Foundations of Time Series Analysis.
Implementing nonparametric methods for TS analysis in clinical practice can benefit clinical decision making and sharpen the diagnostic armory.


More fateful than fruitful? Intracranial pressure monitoring in elderly patients with traumatic brain injury is associated with worse outcomes.
The findings suggest that the use of ICP monitoring according to BTF guidelines in elderly TBI patients does not provide outcomes superior to treatment without monitoring, and the ideal group to benefit from ICP monitor placement remains to be elucidated.
A trial of intracranial pressure monitoring in traumatic brain injury
For patients with severe TBI, care focused on maintaining monitored ICP at 20 mmHg or less was not shown to be superior to care based on imaging and clinical examination.
Effect of intracranial pressure monitoring and targeted intensive care on functional outcome after severe head injury.
ICP/CPP-targeted intensive care results in prolonged mechanical ventilation and increased levels of therapy intensity, without evidence for improved outcome in patients who survive beyond 24 hrs following severe head injury.
Intracranial pressure monitoring in severe head injury: compliance with Brain Trauma Foundation guidelines and effect on outcomes: a prospective study.
Patients managed according to the BTF ICP guidelines experienced significantly improved survival andHypotension, coagulopathy, and increasing age were negatively associated with the placement of ICP monitoring devices.
A trial of intracranial-pressure monitoring in traumatic brain injury.
For patients with severe traumatic brain injury, care focused on maintaining monitored intracranial pressure at 20 mm Hg or less was not shown to be superior to care based on imaging and clinical examination.
Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension.
BACKGROUND The effect of decompressive craniectomy on clinical outcomes in patients with refractory traumatic intracranial hypertension remains unclear. METHODS From 2004 through 2014, we randomly
Decompressive craniectomy in diffuse traumatic brain injury.
In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intrac Cranial pressure and the length of stay in the ICU but was associated with more unfavorable outcomes.
Failure of prophylactic barbiturate coma in the treatment of severe head injury.
A randomized, controlled trial of prophylactic pentobarbital therapy in a group of severely head-injured patients, finding that its use is accompanied by significant side effects which can potentially worsen the condition of a patient with severe head injury.
Targeting Brain Tissue Oxygenation in Traumatic Brain Injury
Whether brain-oxygenation-guided therapy results in improvement in outcomes is debatable, while retrospective studies suggest benefit, while prospective studies have shown a higher intensity of therapeutic interventions with no outcome differences.
Traumatic Brain Injury in Qatar: Age Matters—Insights from a 4-Year Observational Study
Adolescents and adults sustain significant portions of TBI, whereas mortality is much higher in the older group, whereas public awareness and injury prevention campaigns should target young population.