The full statement is available here: The Insertion and Management of External Ventricular Drains: An Evidence-Based Consensus Statement – A Statement for Healthcare Professionals from the Neurocritical Care Society. Published in Neurocritical Care 2016.
Intermittent versus continuous cerebrospinal fluid drainage management in adult severe traumatic brain injury: assessment of intracranial pressure burden. This small cohort study (n=62) from 2014 by Nwachuku EL suggests that continuous drainage is associated with better ICP-control. Read the abstract in Neurocritical Care.
An excellent talk by Shock Trauma’s eminent Thomas Scalea on ICP-management. Funny and insightful. I keep going back to this podcast from 2013 every now and then for a bit of inspiration.
Retrospective cohort study by Patanwala and colleagues including 233 head injured patients that required RSI with either rocuronium or suxamethonium. The results reveal that sux was associated with increased mortality in the most severely injured subset, compared with roc. In patients with less severe injury there was no significant difference between the two NMBs. Interesting… Continue reading Roc or Sux in RSI of TBI Patients?
Useful reading for non-radiologists, Medscape’s overview of the radiological findings associated with Diffuse Axonal Injury (DAI).
“.. infusion of 2 ml kg(-1) during 20 min has a predictable and clinically significant beneficial effect on ICP and CPP.” Predictable reduction of intracranial hypertension with hypertonic saline hydroxyethyl starch: a prospective clinical trial in critically ill patients with subarachnoid hemorrhage. Bentsen et al, Norway. Acta Anaesthesiologica Scandinavica, 2004 Oct. Read the abstract here. Hypertonic… Continue reading SAH-patients: HyperHaes and reduction in ICP (2004)
“There was no difference in the incidence of impairment between hypothermic and normothermic groups” Abstract: Effects of intraoperative hypothermia on neuropsychological outcomes after intracranial aneurysm surgery. Ann Neurol 2006. Anderson et al.
Free full-text via PubMed at: Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST) Investigators. Mild intraoperative hypothermia during surgery for intracranial aneurysm. Todd et al. NEJM 2005. “Intraoperative hypothermia did not improve the neurologic outcome after craniotomy among good-grade patients with aneurysmal subarachnoid haemorrhage”
Pressure-derived versus pressure wave amplitude-derived indices of cerebrovascular pressure reactivity in relation to early clinical state and 12-month outcome following aneurysmal subarachnoid haemorrhage. Abstract of original article by Eide et al. Published in the Journal of Neurosurgery 2012.
Routine intracranial pressure monitoring in acute coma (Cochrane 2015) A recent review of the available literature, pointing to the lack of sufficient evidence concerning the use of ICP monitoring in acute coma. Only one RCT has been conducted (see here) but this trial was questioned on the grounds of a disproportionally high mortality in both… Continue reading Cochrane review of routine ICP measurement in acute coma (2015)
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