Intracranial Pressure and Cerebral Perfusion Pressure Monitoring in Non-TBI Patients: Special Considerations

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• 作者：Raimund Helbok (1)
  DaiWai M. Olson (2)
  Peter D. Le Roux (3)
  Paul Vespa (4)
  The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring
  
  1. Department of Neurology ; Neurocritical Care Unit ; Innsbruck Medical University ; Anichstr. 35 ; 6020 ; Innsbruck ; Austria
  2. Department of Neurology and Neurotherapeutics ; University of Texas Southwestern ; 5323 Harry Hines Blvd. ; Dallas ; TX ; 75390-8897 ; USA
  3. Brain and Spine Center ; Lankenau Medical Center ; Suite 370 ; Medical Science Building ; 100 East Lancaster Avenue ; Wynnewood ; PA ; 19096 ; USA
  4. David Geffen School of Medicine at UCLA ; 757 Westwood Boulevard ; Los Angeles ; CA ; 90095 ; USA
  
• 关键词：ICP ; CPP ; Subarachnoid hemorrhage ; Intracerebral hemorrhage ; Coma ; Brain edema ; Ventriculostomy
• 刊名：Neurocritical Care
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：21
• 期：2-supp
• 页码：85-94
• 全文大小：209 KB
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• 刊物主题：Internal Medicine; Neurology;
• 出版者：Springer US
• ISSN：1556-0961

文摘

The effect of intracranial pressure (ICP) and the role of ICP monitoring are best studied in traumatic brain injury (TBI). However, a variety of acute neurologic illnesses e.g., subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, meningitis/encephalitis, and select metabolic disorders, e.g., liver failure and malignant, brain tumors can affect ICP. The purpose of this paper is to review the literature about ICP monitoring in conditions other than TBI and to provide recommendations how the technique may be used in patient management. A PubMed search between 1980 and September 2013 identified 989 articles; 225 of which were reviewed in detail. The technique used to monitor ICP in non-TBI conditions is similar to that used in TBI; however, indications for ICP monitoring often are intertwined with the presence of obstructive hydrocephalus and hence the use of ventricular catheters is more frequent. Increased ICP can adversely affect outcome, particularly when it fails to respond to treatment. However, patients with elevated ICP can still have favorable outcomes. Although the influence of ICP-based care on outcome in non-TBI conditions appears less robust than in TBI, monitoring ICP and cerebral perfusion pressure can play a role in guiding therapy in select patients.