- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Part 9.1 Anatomy and physiology
- Part 9.2 Neurological monitoring
- Chapter 221 Electroencephalogram monitoring in the critically ill
- Chapter 222 Cerebral blood flow and perfusion monitoring in the critically ill
- Chapter 223 Intracranial pressure monitoring in the ICU
- Chapter 224 Imaging the central nervous system in the critically ill
- Part 9.3 Sleep disturbance
- Part 9.4 Agitation, confusion, and delirium
- Part 9.5 The unconscious patient
- Part 9.6 Seizures
- Part 9.7 Intracranial hypertension
- Part 9.8 Stroke
- Part 9.9 Non-traumatic subarachnoid haemorrhage
- Part 9.10 Meningitis and encephalitis
- Part 9.11 Non-traumatic spinal injury
- Part 9.12 Neuromuscular syndromes
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 1059) Intracranial pressure monitoring in the ICU
- Chapter:
- (p. 1059) Intracranial pressure monitoring in the ICU
- Author(s):
Jonathan K. J. Rhodes
and Peter J. D. Andrews
- DOI:
- 10.1093/med/9780199600830.003.0223
Intracranial pressure (ICP) measurement is an established monitoring modality in the ICU and can aid prognostication after acute brain injury. ICP monitoring is recommended in all patients with severe traumatic brain injury (TBI), and an abnormal cranial computed tomographic (CT) scan and the ability to control ICP is associated with improved outcome after TBI. The lessons from TBI studies can also be applied to other acute pathologies of the central nervous system where ICP can be increased. ICP measurement can warn of impending disaster and allow intervention. Furthermore, measurement of ICP allows the calculation of cerebral perfusion pressure (CPP) and maintenance of CPP may help to ensure adequate cerebral oxygen delivery. Various systems exist to monitor ICP. A recent trial in two South American countries suggested that ICP-guided management and management guided by clinical examination and repeated imaging produced equivalent outcomes. Although this trial currently provides the best evidence regarding the impact of monitoring ICP on outcome following TBI, but because of the inadequate power and questionable external validity, the generalizability of the results remain to be confirmed.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Part 9.1 Anatomy and physiology
- Part 9.2 Neurological monitoring
- Chapter 221 Electroencephalogram monitoring in the critically ill
- Chapter 222 Cerebral blood flow and perfusion monitoring in the critically ill
- Chapter 223 Intracranial pressure monitoring in the ICU
- Chapter 224 Imaging the central nervous system in the critically ill
- Part 9.3 Sleep disturbance
- Part 9.4 Agitation, confusion, and delirium
- Part 9.5 The unconscious patient
- Part 9.6 Seizures
- Part 9.7 Intracranial hypertension
- Part 9.8 Stroke
- Part 9.9 Non-traumatic subarachnoid haemorrhage
- Part 9.10 Meningitis and encephalitis
- Part 9.11 Non-traumatic spinal injury
- Part 9.12 Neuromuscular syndromes
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care