ICP managment
CA-2 · II.C.1.a.2.b
Case context, local only: elective temporal gbm resection
52Sources
72Kept
40Dropped
112 points
Use brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring for continuous ICP evaluation.
PMID 40474297 — not confirmed against the abstract: The sentence adds a clinical recommendation ("Use...") that is not explicitly stated in the abstract, which only describes a shift toward these tools.
dropped
Follow local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management, and perioperative care of decompressed patients.
PMID 34184860
kept
Primary intracranial pressure disorders comprise idiopathic intracranial hypertension and spontaneous intracranial hypotension, which are managed using diagnostic and therapeutic algorithms.
PMID 38431253
kept
Maintain intracranial pressure at 20 mm Hg or lower in severe traumatic brain injury, but adding brain tissue oxygen pressure monitoring to keep above 20 mm Hg does not reduce poor neurological outcome and increases catheter-related intracerebral haematoma risk.
PMID 37863590
kept
Maintain systolic blood pressure lower than 120 mm Hg in most patients with ADPKD, of whom 9% to 14% develop intracranial aneurysms.
PMID 40126492
kept
When intracranial pressure monitoring is unavailable, manage severe traumatic brain injury using tiered suspected intracranial hypertension therapies that escalate and taper.
PMID 32013721
kept
In traumatic brain injury, intracranial pressure monitor placement after 4 or 6 hours does not significantly increase mortality or intensive care unit length of stay.
PMID 40449835
kept
Distinguish idiopathic intracranial hypertension from spontaneous intracranial hypotension, as these primary intracranial pressure disorders require separate diagnostic and therapeutic algorithms.
PMID 38431253 — not confirmed against the abstract: The abstract does not explicitly state the recommendation to distinguish the two disorders or that they require separate algorithms.
dropped
Incorporate brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring into intracranial pressure management for continuous accessible evaluation.
PMID 40474297 — not confirmed against the abstract: The abstract describes a shift toward these tools for continuous accessible evaluation, but does not explicitly recommend incorporating them.
dropped
Manage severe traumatic brain injury using a tiered approach to maintain intracranial pressure below 22 mm Hg and brain tissue oxygenation above 20 mm Hg.
PMID 35273066 — not confirmed against the abstract: The abstract describes a study protocol, not a clinical recommendation to manage severe TBI this way.
dropped
Follow local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management, and perioperative care of decompressed patients.
PMID 34184860
kept
In severe traumatic brain injury, maintain intracranial pressure at 20 mm Hg or lower, since adding brain tissue oxygen monitoring did not reduce poor neurological outcome and increased intracerebral haematoma related to the catheter.
PMID 37863590
kept
When intracranial pressure monitoring is not employed in severe traumatic brain injury, organize suspected intracranial hypertension treatment modalities into tiers to guide treatment escalation and tapering.
PMID 32013721
kept
Intracranial pressure monitor placement within four to six hours does not reduce mortality or intensive care unit length of stay compared with later placement in traumatic brain injury.
PMID 40449835
kept
In the acute setting of suspected elevated intracranial pressure, employ neuroprotective intubation and ventilation strategies during the initial minutes to hours of resuscitation.
PMID 36802976
kept
Hyperosmolar therapy may reduce ICP elevations or cerebral edema in SAH, TBI, AIS, ICH, and HE, but neurological outcomes do not appear affected.
PMID 32227294
kept
In severe traumatic brain injury, use a tiered approach to maintain intracranial pressure below 22 mm Hg and brain tissue oxygenation above 20 mm Hg.
PMID 35273066 — not confirmed against the abstract: The abstract describes an ongoing study protocol, not a proven clinical recommendation, and does not recommend this approach as a clinical teaching point.
dropped
In severely brain-injured patients, employ brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring to continuously evaluate intracranial dynamics.
PMID 40474297 — not confirmed against the abstract: the sentence adds a prescriptive recommendation ("employ") that the abstract does not explicitly state, as the abstract only notes that ICP management is shifting toward these tools.
dropped
In severe traumatic brain injury without intracranial pressure monitoring, suspected intracranial hypertension should trigger tiered treatment escalation and tapering guided by imaging, clinical examination, and scheduled targeting of disease severity.
PMID 32013721 — not confirmed against the abstract: The abstract describes the CREVICE algorithm as a consensus-based resource, not a clinical recommendation, and the sentence adds a directive ("should trigger") not stated in the abstract.
dropped
Adopt local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management, and perioperative care of decompressed patients.
PMID 34184860
kept
Apply diagnostic and therapeutic algorithms when managing idiopathic intracranial hypertension and spontaneous intracranial hypotension, which are primary intracranial pressure disorders.
PMID 38431253
kept
Early intracranial pressure monitoring within four to six hours does not significantly reduce mortality, hospital length of stay, or intensive care unit length of stay compared to late monitoring in traumatic brain injury.
PMID 40449835
kept
In traumatic brain injury patients requiring intracranial pressure therapy, targeting cerebral perfusion pressure within 5 mm Hg of the autoregulation-guided optimal value is feasible and safe, with 46.5% of monitored time in target range and no increased therapeutic intensity.
PMID 34407385
kept
In the first minutes to hours of resuscitation for suspected elevated intracranial pressure, employ noninvasive maneuvers, neuroprotective intubation and ventilation strategies, and pharmacologic therapies such as ketamine, lidocaine, corticosteroids, mannitol, or hypertonic saline.
PMID 36802976
kept
Corticosteroids appear helpful in reducing cerebral edema in bacterial meningitis but not intracerebral hemorrhage.
PMID 32227294
kept
In severe TBI, use a tiered approach to maintain ICP <22 mm Hg and PbtO2 >20 mm Hg, as cerebral hypoxia can occur despite normal ICP.
PMID 35273066 — not confirmed against the abstract: The abstract describes the tiered approach as the trial's protocol, not as a clinical recommendation to "use" it.
dropped
In TBI patients requiring ICP monitoring, target the autoregulation-guided optimal cerebral perfusion pressure within ±5 mm Hg, a strategy maintained 46.5% of the time with no significant increase in therapeutic intensity level.
PMID 34407385 — not confirmed against the abstract: The sentence adds a clinical recommendation to target CPP within ±5 mm Hg, whereas the abstract only reports this as a feasibility metric and concludes that a prospective trial is needed.
dropped
Follow local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management, and perioperative care of decompressed patients.
PMID 34184860
kept
In traumatic brain injury, delaying intracranial pressure monitoring beyond 4 or 6 hours does not significantly increase mortality, hospital length of stay, or intensive care unit length of stay.
PMID 40449835
kept
Impairments in cerebrovascular autoregulation, brain compartmentalization, and the glymphatic system interact in severely brain-injured patients, calling for new management strategies.
PMID 40474297
kept
When intracranial pressure monitoring is unavailable in severe traumatic brain injury, manage suspected intracranial hypertension using tiered treatment modalities that escalate and taper with disease severity.
PMID 32013721
kept
After endovascular thrombectomy, intensive systolic blood pressure control reduces functional independence (RR 0.81) compared with conventional targets, favoring conservative post-recanalization management.
PMID 38386320
kept
During initial resuscitation for suspected elevated intracranial pressure, employ noninvasive maneuvers, neuroprotective intubation and ventilation strategies, and pharmacologic therapies such as ketamine, lidocaine, corticosteroids, mannitol, and hypertonic saline.
PMID 36802976
kept
For TBI patients requiring ICP therapy, target CPP within 5 mm Hg of the autoregulation-guided optimal value, as this concordance was maintained 46.5% of the time without increased therapeutic intensity.
PMID 34407385 — not confirmed against the abstract: The abstract reports feasibility and safety but does not recommend targeting CPP within 5 mm Hg of the optimal value as a clinical practice, as it was only a feasibility trial encouraging a future trial powered for clinical outcomes.
dropped
Adopt local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management, and perioperative care of decompressed patients to improve treatment efficiency.
PMID 34184860
kept
In traumatic brain injury, intracranial pressure monitor placement within four or six hours does not significantly reduce mortality compared to late placement.
PMID 40449835
kept
In severe traumatic brain injury, maintain intracranial pressure below 22 mm Hg and brain tissue oxygenation above 20 mm Hg when both monitors are used.
PMID 35273066
kept
In traumatic brain injury, no significant mortality difference exists between intracranial pressure monitoring placed within four or six hours and later placement, with relative risk 0.98.
PMID 40449835
kept
Incorporate brain ultrasound, automated pupillometry, or noninvasive pressure waveform monitoring into a holistic monitoring approach for continuous intracranial dynamics evaluation in severely brain-injured patients.
PMID 40474297
kept
In severe traumatic brain injury without intracranial pressure monitoring, identify suspected intracranial hypertension by imaging and clinical examination, and organize treatment modalities into tiers to guide escalation and tapering.
PMID 32013721
kept
Hypertonic saline is associated with a relative risk of 2.13 for adverse hypernatremia compared with other intracranial-pressure-lowering agents in traumatic brain injury with no evidence of effect on six-month Glasgow Outcome Scale scores.
PMID 37380894
kept
In TBI patients requiring ICP monitoring, maintain CPP within ±5 mm Hg of the individual and dynamic cerebral autoregulation-guided target, as this is feasible and safe without increasing therapeutic intensity.
PMID 34407385 — not confirmed against the abstract: The sentence adds a clinical recommendation to maintain CPP within a specific range, whereas the abstract only reports feasibility and safety and explicitly calls for a prospective trial powered for clinical outcomes.
dropped
Use brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring to provide accessible and continuous ICP evaluation in brain-injured patients.
PMID 40474297 — not confirmed against the abstract: The sentence adds a recommendation ("Use...") that is not explicitly stated in the abstract, which only describes a shift in management strategies.
dropped
Do not rely on out-of-hospital tranexamic acid within two hours of injury to reduce progression of intracranial hemorrhage in moderate or severe traumatic brain injury with Glasgow Coma Scale score of 12 or less versus placebo.
PMID 32897344 — not confirmed against the abstract: The sentence adds a clinical recommendation ("Do not rely on") that is not explicitly stated in the abstract.
dropped
Administer corticosteroids to reduce cerebral edema in bacterial meningitis, but avoid them in intracerebral hemorrhage because they do not appear helpful.
PMID 32227294 — not confirmed against the abstract: The abstract states corticosteroids are helpful in bacterial meningitis but not ICH, but it does not explicitly recommend administering or avoiding them.
dropped
Give HTS to reduce ICP by 35.9% in TBI, as it has relatively similar efficacy to mannitol in boosting neurological condition and reducing mortality.
PMID 36404350 — not confirmed against the abstract: The sentence adds a clinical recommendation ("Give HTS") that is not stated in the abstract.
dropped
Adopt local multidisciplinary protocols regarding thresholds of ICP values, drug therapies, hemostasis management and perioperative care of decompressed patients.
PMID 34184860
kept
In traumatic brain injury, intracranial pressure monitor placement within 4 or 6 hours shows no significant mortality or intensive care unit length of stay advantage over delayed placement.
PMID 40449835
kept
In severe traumatic brain injury without intracranial pressure monitoring, organize suspected intracranial hypertension treatment modalities into tiers to escalate and taper treatment based on imaging and clinical examination.
PMID 32013721
kept
Hypertonic saline for traumatic brain injury carries a higher risk of adverse hypernatremia than other intracranial-pressure-lowering agents, with no evidence of improved six-month Glasgow Outcome Scale scores or mortality benefit.
PMID 37380894
kept
Manage suspected acutely elevated intracranial pressure with noninvasive maneuvers, neuroprotective intubation and ventilation strategies, and pharmacologic therapies including ketamine, lidocaine, corticosteroids, mannitol, or hypertonic saline before the etiology is known.
PMID 36802976
kept
In TBI patients requiring intracranial pressure therapy, individualize cerebral perfusion pressure targets to within 5 mm Hg of the autoregulation-guided optimal value, which was maintained 46.5% of monitored time without increased therapeutic intensity.
PMID 34407385 — not confirmed against the abstract: The sentence adds a clinical recommendation to individualize targets, whereas the abstract only concludes the approach is feasible and safe and encourages a future prospective trial.
dropped
Manage intracranial dynamics by accounting for interactions among the three incompressible cranial vault components: brain tissue, blood, and cerebrospinal fluid.
PMID 40474297 — not confirmed against the abstract: The abstract explains the doctrine's focus on the three components but does not recommend managing intracranial dynamics by accounting for them.
dropped
Give hypertonic saline for elevated intracranial pressure in traumatic brain injury because it reduces ICP by 35.9% with efficacy similar to mannitol.
PMID 36404350 — not confirmed against the abstract: the abstract reports efficacy but does not explicitly recommend giving HTS.
dropped
Adopt local multidisciplinary protocols for ICP thresholds, drug therapies, hemostasis management, and perioperative care of decompressed patients to improve treatment efficiency.
PMID 34184860
kept
In traumatic brain injury, intracranial pressure monitor placement before or after four or six hours demonstrates no significant mortality difference, with relative risk 0.98 and 95% confidence interval 0.56 to 1.71.
PMID 40449835
kept
When intracranial pressure monitoring is not employed in severe traumatic brain injury, escalate and taper suspected intracranial hypertension treatment through tiered modalities according to disease severity schedules.
PMID 32013721
kept
Hypertonic saline is associated with adverse hypernatremia compared with other intracranial-pressure-lowering agents in traumatic brain injury without evidence of effect on mortality or six-month Glasgow Outcome Scale score.
PMID 37380894
kept
Out-of-hospital tranexamic acid 1 g bolus plus 1 g infusion or 2 g bolus alone within 2 hours did not significantly reduce progression of intracranial hemorrhage compared with placebo in moderate or severe traumatic brain injury.
PMID 32897344
kept
In the first minutes to hours of suspected elevated intracranial pressure, employ neuroprotective intubation and ventilation strategies and administer pharmacologic therapies including ketamine, lidocaine, corticosteroids, mannitol, or hypertonic saline.
PMID 36802976
kept
In TBI patients requiring ICP monitoring, target an individualized cerebral autoregulation-guided CPP and maintain it within ±5 mm Hg, as this strategy is feasible and safe.
PMID 34407385 — not confirmed against the abstract: The abstract does not recommend clinical implementation, but rather encourages a prospective trial powered for clinical outcomes.
dropped
Use brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring to shift neuromonitoring toward continuous and accessible intracranial dynamics evaluation.
PMID 40474297 — not confirmed against the abstract: The sentence adds a recommendation ("Use...") that the abstract does not state; the abstract only describes the shift toward these tools.
dropped
Employ cerebrospinal fluid drainage and hyperosmolar therapies in severe pediatric traumatic brain injury.
PMID 37801113 — not confirmed against the abstract: the abstract reports that a trial advanced knowledge on these therapies, but does not recommend employing them.
dropped
Corticosteroids appear helpful in reducing cerebral edema in bacterial meningitis but not intracerebral hemorrhage, and they should not be used for intracranial pressure management in intracerebral hemorrhage.
PMID 32227294 — not confirmed against the abstract: the abstract states corticosteroids are not helpful in reducing cerebral edema in ICH, but it does not recommend against their use for intracranial pressure management in ICH.
dropped
Use hypertonic saline as an alternative to mannitol for traumatic brain injury because it reduces intracranial pressure by 35.9% with similar efficacy.
PMID 36404350 — not confirmed against the abstract: The sentence adds a clinical recommendation ("Use hypertonic saline as an alternative to mannitol") that is not explicitly stated in the abstract.
dropped
Adopt local multidisciplinary protocols for hemostasis management and perioperative care of decompressed patients to improve treatment efficiency.
PMID 34184860
kept
In traumatic brain injury, a 4- or 6-hour cutoff for early versus late ICP monitor placement yields no significant difference in mortality or hospital and ICU length of stay.
PMID 40449835
kept
In severe traumatic brain injury without intracranial pressure monitoring, organize suspected intracranial hypertension treatment into tiers that guide escalation and tapering via targeted schedules.
PMID 32013721
kept
Hypertonic saline carries a relative risk of 2.13 for adverse hypernatremia compared with other intracranial-pressure-lowering agents in traumatic brain injury.
PMID 37380894
kept
Decompressive craniectomy for refractory traumatic intracranial pressure above 25 mm Hg reduces median time above that threshold from 17.0 hours to 5.0 hours but increases adverse events from 9.2% to 16.3%.
PMID 27602507
kept
In TBI patients requiring ICP monitoring, use cerebral autoregulation-guided optimal CPP targets rather than BTF guideline CPP target range, since this approach was feasible and safe without increasing therapeutic intensity or other safety endpoints.
PMID 34407385 — not confirmed against the abstract: The abstract does not recommend using CA-guided CPP targets over BTF guidelines in practice; it only concludes feasibility and safety and encourages a future trial powered for clinical outcomes.
dropped
Use brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring to shift severe brain injury management toward continuous ICP evaluation.
PMID 40474297 — not confirmed against the abstract: The sentence adds a recommendation ("Use...") that the abstract does not state, instead describing a shift that is already occurring.
dropped
Use hyperosmolar therapies and cerebrospinal fluid drainage in severe pediatric traumatic brain injury.
PMID 37801113 — not confirmed against the abstract: the abstract mentions a trial advanced knowledge on the use of these therapies, but does not recommend using them.
dropped
In severe traumatic brain injury during the first 24 hours, employ intracerebral monitoring, cerebral perfusion pressure management, and medical management of raised intracranial pressure.
PMID 29288841 — not confirmed against the abstract: The abstract lists these as topics of the guidelines, but does not explicitly state the recommendation to employ them.
dropped
Administer hypertonic saline as an alternative to mannitol for elevated intracranial pressure in traumatic brain injury because it reduces ICP by 35.9%.
PMID 36404350 — not confirmed against the abstract: The sentence adds a clinical recommendation to administer HTS as an alternative to mannitol, which is not stated in the abstract.
dropped
In severe traumatic brain injury without intracranial pressure monitoring, organize suspected intracranial hypertension treatments into tiers to guide escalation and tapering.
PMID 32013721
kept
Corticosteroids appear helpful in reducing cerebral edema in bacterial meningitis but not ICH.
PMID 32227294
kept
Intracranial pressure exceeding 25 mm Hg defines refractory intracranial hypertension, and decompressive craniectomy reduces median hours above this threshold from 17.0 to 5.0 but increases adverse events from 9.2% to 16.3% without improving rates of moderate disability or good recovery.
PMID 27602507
kept
Hypertonic saline did not significantly reduce uncontrolled ICP compared with other agents and carried a 2.13-fold relative risk of adverse hypernatremia.
PMID 37380894 — PMID check failed: pubmed 429 for https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esummary.fcgi?db=pubmed&id=37380894&retmode=json&tool=intraop-teaching
dropped
In TBI patients requiring ICP monitoring, maintain cerebral autoregulation-guided individualized CPP within ±5 mm Hg of the dynamic optimal value, as this approach is feasible and safe.
PMID 34407385 — not confirmed against the abstract: The abstract concludes that the approach is feasible and safe and encourages a future prospective trial, but it does not recommend maintaining this target in clinical practice.
dropped
Do not administer corticosteroids for cerebral edema in intracerebral hemorrhage, as they do not appear helpful.
PMID 32227294 — not confirmed against the abstract: The abstract states corticosteroids are not helpful in ICH but does not explicitly recommend not administering them.
dropped
Manage severe paediatric traumatic brain injury with hyperosmolar therapies and cerebrospinal fluid drainage.
PMID 37801113 — not confirmed against the abstract: The abstract states a trial advanced knowledge on the use of these therapies, but does not recommend managing TBI with them.
dropped
In severe traumatic brain injury during the first 24 hours, use intracerebral monitoring, cerebral perfusion pressure management, sedation, analgesia, and biological homeostasis of osmolarity and glycaemia in the medical management of raised intracranial pressure.
PMID 29288841 — not confirmed against the abstract: The abstract lists these as separate guideline topics but does not recommend using them specifically for the medical management of raised intracranial pressure, nor does it state sedation/analgesia and biological homeostasis are part of ICP management.
dropped
Administer hypertonic saline for elevated intracranial pressure in traumatic brain injury, as it reduces intracranial pressure by 35.9% with efficacy relatively similar to mannitol.
PMID 36404350 — not confirmed against the abstract: The sentence adds a clinical recommendation ("Administer hypertonic saline...") that is not explicitly stated in the abstract, which only reports findings and states HTS is a treatment base.
dropped
Organize suspected intracranial hypertension treatment into tiers to guide treatment escalation and tapering when intracranial pressure monitoring is not available.
PMID 32013721
kept
In traumatic brain injury, early intracranial pressure monitoring within six hours does not significantly reduce mortality compared to late monitoring.
PMID 40449835
kept
In severe brain injury, interacting impairments in cerebrovascular autoregulation, brain compartmentalization, and the glymphatic system call for new management strategies.
PMID 40474297
kept
In traumatic brain injury, hypertonic saline more than doubles the risk of adverse hypernatremia compared with other intracranial-pressure-lowering agents without evidence of effect on six-month Glasgow Outcome Scale scores or mortality.
PMID 37380894
kept
In traumatic brain injury with refractory intracranial pressure above 25 mm Hg, decompressive craniectomy reduces median hours of ICP elevation from 17.0 to 5.0 but increases adverse events from 9.2% to 16.3%.
PMID 27602507
kept
In traumatic brain injury, delaying intracranial pressure monitor placement beyond four to six hours demonstrates no significant mortality difference versus early placement, allowing emergent surgery to take priority.
PMID 40449835 — not confirmed against the abstract: the abstract reports no significant mortality difference but does not state that emergent surgery should take priority.
dropped
Target an individualized cerebral autoregulation-guided cerebral perfusion pressure in traumatic brain injury patients requiring intracranial pressure monitoring, as this was concordant within 5 mm Hg for 46.5% of monitored time with no significant difference in therapeutic intensity level.
PMID 34407385 — not confirmed against the abstract: The sentence adds a recommendation to target CA-guided CPP, whereas the abstract only concludes it is feasible and safe and encourages a future prospective trial powered for clinical outcomes.
dropped
Manage severely brain-injured patients by addressing interacting impairments in cerebrovascular autoregulation, brain compartmentalization, and the glymphatic system rather than intracranial pressure alone.
PMID 40474297 — not confirmed against the abstract: The abstract calls for new management strategies for these interacting impairments but does not recommend addressing them "rather than intracranial pressure alone."
dropped
Use hyperosmolar therapies and cerebrospinal fluid drainage in severe paediatric traumatic brain injury.
PMID 37801113 — not confirmed against the abstract: The abstract mentions a trial advanced knowledge on the use of these therapies, but does not recommend their use.
dropped
Hyperosmolar therapy may reduce ICP elevations in traumatic brain injury, but neurological outcomes do not appear affected.
PMID 32227294
kept
Manage severe traumatic brain injury in the first 24 hours with sedation and analgesia, intracerebral monitoring, cerebral perfusion pressure management, and medical treatment of raised intracranial pressure.
PMID 29288841
kept
In acute traumatic brain injury, hypertonic saline increases adverse hypernatremia risk relative to other ICP-lowering agents with a risk ratio of 2.13, with no evidence of improved mortality or six-month Glasgow Outcome Scale score.
PMID 37380894
kept
Decompressive craniectomy for refractory intracranial pressure above 25 mm Hg lowers six-month mortality but yields higher rates of vegetative state, lower severe disability, and upper severe disability, with similar moderate disability and good recovery.
PMID 27602507
kept
Acute intracerebral hemorrhage warrants early aggressive goal-directed treatment to prevent secondary brain injury and control intracranial pressure.
PMID 26022637
kept
In traumatic brain injury, hypertonic saline reduces intracranial pressure by 35.9% and offers similar efficacy to mannitol for improving neurological outcomes and reducing mortality.
PMID 36404350
kept
This guideline found corticosteroids appear helpful in reducing cerebral edema in bacterial meningitis but not intracerebral hemorrhage.
PMID 32227294
kept
This meta-analysis found no significant mortality difference between early—defined by 4-hour or 6-hour cutoffs—and late intracranial pressure monitoring in traumatic brain injury patients.
PMID 40449835
kept
This randomized trial found that TBI patients requiring ICP therapy spent 46.5% of monitored time within 5 mm Hg of an individualized autoregulation-guided CPP target with no significant between-group difference in therapeutic intensity level.
PMID 34407385
kept
This review reports that brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring are shifting ICP management toward more accessible and continuous evaluation strategies in severely brain-injured patients.
PMID 40474297
kept
This guideline recommends updated first-24-hour strategies for intracerebral monitoring, cerebral perfusion pressure management, and medical management of raised intracranial pressure in severe traumatic brain injury.
PMID 29288841
kept
This meta-analysis found that in acute traumatic brain injury, hypertonic saline was associated with adverse hypernatremia versus other intracranial-pressure-lowering agents with relative risk 2.13 but no evidence of effect on six-month Glasgow Outcome Scale scores or mortality.
PMID 37380894
kept
This 2020 Neurocritical Care Society guideline found hyperosmolar therapy may be helpful in reducing ICP elevations or cerebral edema in SAH, TBI, AIS, ICH, and hepatic encephalopathy, though neurological outcomes do not appear affected.
PMID 32227294 — not confirmed against the abstract: The abstract does not state the guideline is from 2020.
dropped
This meta-analysis found no significant mortality difference between early and late ICP monitor placement in traumatic brain injury using 4- or 6-hour cutoffs.
PMID 40449835
kept
This feasibility randomized trial found that in traumatic brain injury patients requiring intracranial pressure monitoring, cerebral perfusion pressure was within 5 mm Hg of autoregulation-guided targets for 46.5% of time without increased therapeutic intensity versus Brain Trauma Foundation targets.
PMID 34407385
kept
This review reports that brain ultrasound, automated pupillometry, and noninvasive pressure waveform monitoring are shifting ICP management toward more accessible and continuous evaluation strategies in severely brain-injured patients.
PMID 40474297
kept
This meta-analysis found hypertonic saline was associated with adverse hypernatremia compared with other intracranial-pressure-lowering agents in acute traumatic brain injury, with a risk ratio of 2.13 (95% CI 1.09–4.17).
PMID 37380894
kept
This randomized trial found that among patients 10 to 65 years old with refractory traumatic intracranial pressure over 25 mm Hg, decompressive craniectomy lowered six-month mortality to 26.9% versus 48.9% with medical care but increased rates of vegetative state and severe disability.
PMID 27602507
kept
The guideline recommends managing raised intracranial pressure and biological homeostasis of osmolarity, glycaemia, and adrenal axis in severe traumatic brain injury during the first 24 hours.
PMID 29288841 — PMID check failed: pubmed 429 for https://eutils.ncbi.nlm.nih.gov/entrez/eutils/esummary.fcgi?db=pubmed&id=29288841&retmode=json&tool=intraop-teaching
dropped
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