About interrelation of intracranial pressure and cerebral blood flow when positioning at patients with acute brain damage

Abstract

Changing of «head – of – the bed» position is a routine method of positioning the patient to correct intracranial hypertension. In intensive care units, the «head – of – the bed» position vary from 0 to 60 °, and there is no consensus on which of them is most effective. The review of the major publications in the domestic and foreign literature about the problem of interrelation between positioning and changes of intracranial pressure, system and cerebral hemodynamic in patients with brain damage including databases eLibrary, PubMed, with the key words «hyperthermia», « positioning», «slope angle of the head of bed», «intracranial pressure», «cerebral perfusion pressure», «cerebral blood flow», «brain damage», and their combination. It is believed that the majority of patients with cerebral damage, regardless of the etiological factor, is preferable to 15–30° «head – of – the bed» position. In some cases manipulation of the head of the bed can lead to irreversible ischemic damage, due to the reduction of system and perfusion pressure, and cerebral blood flow. Thus, the selection of the optimal body position in acute cerebral pathology remains a debated issue. In this way, individual tactics of positioning in patients with cerebral damage allows choosing the correct intensive care and improving the treatment results.