Intracranial pressure: current perspectives on physiology and monitoring.
Critical care
Intracranial hypertension
Intracranial pressure
Monitoring
Non-invasive
Physiology
Traumatic brain injury
Journal
Intensive care medicine
ISSN: 1432-1238
Titre abrégé: Intensive Care Med
Pays: United States
ID NLM: 7704851
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
01
05
2022
accepted:
08
06
2022
pubmed:
12
7
2022
medline:
15
9
2022
entrez:
11
7
2022
Statut:
ppublish
Résumé
Intracranial pressure (ICP) monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. It serves to warn of expanding intracranial mass lesions, to prevent or treat herniation events as well as pressure elevation which impedes nutrient delivery to the brain. It facilitates the calculation of cerebral perfusion pressure (CPP) and the estimation of cerebrovascular autoregulatory status. Despite advancements in our knowledge emanating from a half century of experience with this technology, important controversies remain related even to fundamental aspects of ICP measurements, including indications for monitoring, ICP treatment thresholds, and management of intracranial hypertension. Here, we review the history of ICP monitoring, the underlying pathophysiology as well as current perspectives on why, when and how ICP monitoring is best used. ICP is typically assessed invasively but a number of emerging, non-invasive technologies with inherently lower risk are showing promise. In selected cases, additional neuromonitoring can be used to assist in the interpretation of ICP monitoring information and adapt directed treatment accordingly. Additional efforts to expand the evidence base relevant to ICP monitoring, related technologies and management remain a high priority in neurosurgery and neurocritical care.
Identifiants
pubmed: 35816237
doi: 10.1007/s00134-022-06786-y
pii: 10.1007/s00134-022-06786-y
doi:
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1471-1481Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Type : ErratumIn
Informations de copyright
© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.
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