Abstract
Duration of intracranial pressure (ICP) monitoring depends on the clinician`s necessity for the data that influence type and length of the management of intracranial hypertension (ICHT). On the other hand, it is also affected by the possibility of the development of the infection, which is very often fatal when it occurs in the central nervous system. A prospective study of the 32 patients with severe brain trauma (SBT) that had intracranial pressure (ICP) monitoring is presented in here. There were 22 patients with intracranial hypertension (ICHT) and 10 without it. In the ICHT group, the monitoring lasted 5.81 ± 2.70 and 4.45 ± 1.81 in the control group. We have not found a significant difference in the duration of the ICP monitoring between two groups (t = 1.71, p > 0.05). Patients with ICHT had significantly shorter survival than the control group (p = 0.04). It seems that need for prolonged monitoring of the patients with ICHT is suppressed by their shorter survival, comparing to brain-injured patients with normal intracranial pressure.
Highlights
The essential purpose of the intracranial pressure (ICP) monitoring is the adequate therapy of the patients
Patients with intracranial hypertension (ICHT) had significantly shorter survival than the control group (p = 0.04). It seems that need for prolonged monitoring of the patients with ICHT is suppressed by their shorter survival, comparing to brain-injured patients with normal intracranial pressure
We have determined ICHT in 22 (68.75%) of the monitored patients, 10 (31.25%) of them did not meet the criteria of intracranial hypertension, and that was the control group
Summary
The essential purpose of the ICP monitoring is the adequate therapy of the patients. Clinicians are capable of performing specific or ultimate therapy options after obtaining the information from the ICP monitor. Specific therapy options include deep sedation, drainage of some amount of CSF from the ventricle, hyperventilation up to pCO2 = 30-35 mmHg and intensifying antiedematous therapy. Ultimate therapies are high dose barbiturate treatment, hyperventilation up to pCO2 = 25-30 mmHg, hypothermia, and decompressive treatment (1). Numerous treatment options suggest that neither of them is highly effective and that only their successive application or combination could be of some benefit for the patient with severe brain injury (SBI). The longer ICP moniwww.medfak.ni.ac.rs/amm toring usually means a bigger chance of successful treatment of the SBI patients
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