Intracranial pressure: more than a number

Czosnyka, Marek, Smielewski, Peter, Timofeev, Ivan, Lavinio, Andrea, Guazzo, Eric, Hutchinson, Peter, and Pickard, John D. (2007) Intracranial pressure: more than a number. Neurosurgical Focus, 22 (5). pp. 1-7.

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Abstract

Many doctors involved in the critical care of head-injured patients understand intracranial pressure (ICP) as a number, characterizing the state of the brain pressure–volume relationships. However, the dynamics of ICP, its waveform, and secondarily derived indices portray useful information about brain homeostasis. There is circumstantial evidence that this information can be used to modify and optimize patients' treatment. Secondary variables, such as pulse amplitude and the magnitude of slow waves, index of compensatory reserve, and pressure–reactivity index (PRx), look promising in clinical practice. The optimal cerebral perfusion pressure (CPP) derived using the PRx is a new concept that may help to avoid excessive use of vasopressors in CPP-oriented therapy. However, the use of secondary ICP indices remains to be confirmed in clinical trials.

Item ID: 2223
Item Type: Article (Refereed Research - C1)
Keywords: cerebrovascular reactivity; head injury; intracranial pressure monitoring; pressure volume compensation;
ISSN: 1092-0684
Date Deposited: 28 May 2009 01:27
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110323 Surgery @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 50%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920111 Nervous System and Disorders @ 51%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 49%
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