Intracranial Pressure Monitoring and Treatment Thresholds in Acute Neural Injury: A Narrative Review of the Historical Achievements, Current State, and Future Perspectives

颅内压 创伤性脑损伤 医学 重症监护医学 神经重症监护 脑灌注压 背景(考古学) 叙述性评论 指南 脑血流 心理干预 第七节 颅内压监测 麻醉 病理 精神科 古生物学 生物
作者
Kevin Y. Stein,Logan Froese,Alwyn Gomez,Amanjyot Singh Sainbhi,Nuray Vakitbilir,Younis Ibrahim,Frederick A. Zeiler
出处
期刊:Neurotrauma reports [Mary Ann Liebert]
卷期号:4 (1): 478-494 被引量:1
标识
DOI:10.1089/neur.2023.0031
摘要

Since its introduction in the 1960s, intracranial pressure (ICP) monitoring has become an indispensable tool in neurocritical care practice and a key component of the management of moderate/severe traumatic brain injury (TBI). The primary utility of ICP monitoring is to guide therapeutic interventions aimed at maintaining physiological ICP and preventing intracranial hypertension. The rationale for such ICP maintenance is to prevent secondary brain injury arising from brain herniation and inadequate cerebral blood flow. There exists a large body of evidence indicating that elevated ICP is associated with mortality and that aggressive ICP control protocols improve outcomes in severe TBI patients. Therefore, current management guidelines recommend a cerebral perfusion pressure (CPP) target range of 60–70 mm Hg and an ICP threshold of >20 or >22 mm Hg, beyond which therapeutic intervention should be initiated. Though our ability to achieve these thresholds has drastically improved over the past decades, there has been little to no change in the mortality and morbidity associated with moderate-severe TBI. This is a result of the "one treatment fits all" dogma of current guideline-based care that fails to take individual phenotype into account. The way forward in moderate-severe TBI care is through the development of continuously derived individualized ICP thresholds. This narrative review covers the topic of ICP monitoring in TBI care, including historical context/achievements, current monitoring technologies and indications, treatment methods, associations with patient outcome and multi-modal cerebral physiology, present controversies surrounding treatment thresholds, and future perspectives on personalized approaches to ICP-directed therapy.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
文艺鞋垫发布了新的文献求助20
刚刚
NexusExplorer应助执着的安蕾采纳,获得10
刚刚
善学以致用应助yu采纳,获得10
1秒前
斯文千柳完成签到,获得积分10
1秒前
小绵羊发布了新的文献求助10
1秒前
WUQINGHALASHAO完成签到,获得积分10
3秒前
畅小狮给畅小狮的求助进行了留言
3秒前
害怕的擎宇完成签到,获得积分10
3秒前
传奇3应助科研通管家采纳,获得10
4秒前
科研通AI2S应助科研通管家采纳,获得10
4秒前
英姑应助科研通管家采纳,获得10
4秒前
脑洞疼应助科研通管家采纳,获得10
4秒前
科目三应助科研通管家采纳,获得10
4秒前
Akim应助科研通管家采纳,获得10
4秒前
寻道图强应助科研通管家采纳,获得30
4秒前
小丸子完成签到,获得积分10
4秒前
4秒前
在水一方应助科研通管家采纳,获得10
4秒前
深情安青应助科研通管家采纳,获得10
4秒前
4秒前
脑洞疼应助科研通管家采纳,获得10
5秒前
青衍应助科研通管家采纳,获得10
5秒前
zyr应助科研通管家采纳,获得10
5秒前
搜集达人应助科研通管家采纳,获得10
5秒前
华仔应助科研通管家采纳,获得10
5秒前
田様应助科研通管家采纳,获得10
5秒前
陈军应助科研通管家采纳,获得20
5秒前
李健应助科研通管家采纳,获得10
5秒前
科目三应助科研通管家采纳,获得10
5秒前
浅尝离白应助科研通管家采纳,获得30
5秒前
5秒前
5秒前
5秒前
5秒前
6秒前
华仔应助jkq采纳,获得10
6秒前
pingping发布了新的文献求助10
6秒前
hanxuepenyun发布了新的文献求助10
6秒前
Amie完成签到,获得积分10
7秒前
xiaoGuo应助穿风衣的猫采纳,获得20
7秒前
高分求助中
Kinetics of the Esterification Between 2-[(4-hydroxybutoxy)carbonyl] Benzoic Acid with 1,4-Butanediol: Tetrabutyl Orthotitanate as Catalyst 1000
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Very-high-order BVD Schemes Using β-variable THINC Method 568
Chen Hansheng: China’s Last Romantic Revolutionary 500
XAFS for Everyone 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3138230
求助须知:如何正确求助?哪些是违规求助? 2789160
关于积分的说明 7790351
捐赠科研通 2445545
什么是DOI,文献DOI怎么找? 1300521
科研通“疑难数据库(出版商)”最低求助积分说明 625925
版权声明 601046