Routine intracranial pressure monitoring in acute coma

Forsyth, Rob; Raper, Joseph; Todhunter, Emma

doi:10.1002/14651858.cd002043.pub3

Cited by 39 publications

(8 citation statements)

References 42 publications

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“…MAP can be increased by vasopressors to increase CPP. A CPP of at least 50 mmHg has been associated with an improved outcome in traumatic brain injury, but no such correlation between CPP and outcome has been identified in non-traumatic brain injury ( 31 ).…”

Section: Invasive Meningococcal Diseasementioning

confidence: 99%

Invasive Meningococcal Disease in the Vaccine Era

Nadel

Ninis

2018

Front. Pediatr.

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Infection with the meningococcus is one of the main causes of meningitis and septicaemia worldwide. Humans are the only natural reservoir for the meningococcus which is found primarily as a commensal inhabitant in the nasopharynx in ~10% of adults, and may be found in over 25% of individuals during adolescence. Prompt recognition of meningococcal infection and early aggressive treatment are essential in order to reduce mortality, which occurs in up to 10% of those with invasive meningococcal disease (IMD). This figure may be significantly higher in those with inadequate or delayed treatment. Early administration of effective parenteral antimicrobial therapy and prompt recognition and appropriate management of the complications of IMD, including circulatory shock and raised intracranial pressure (ICP), are critical to help improve patient outcome. This review summarizes clinical features of IMD and current treatment recommendations. We will discuss the evidence for immunization and effects of vaccine strategies, particularly following implementation of effective vaccines against Group B meningococcus.

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Section: Invasive Meningococcal Diseasementioning

confidence: 99%

Invasive Meningococcal Disease in the Vaccine Era

Nadel

Ninis

2018

Front. Pediatr.

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“…25 Although a Cochrane review on the topic was published recently, no study was analyzed because only randomized trials were included. 9 Without considering observational studies, the review was unable to provide any conclusion as to the value of ICP monitoring in patients with TBI. Thus, we conducted a meta-analysis of ICP monitoring studies, including observational studies, to evaluate the evidence of a relationship between the use of ICP monitoring and outcome in patients with TBI.…”

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confidence: 99%

Impact of intracranial pressure monitoring on mortality in patients with traumatic brain injury: a systematic review and meta-analysis

Yuan¹,

Wu²,

Sun³

et al. 2015

JNS

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T raumaTic brain injury (TBI) is a common cause of death and disability worldwide. 17 Despite some claims to the contrary, no clear decrease in severe TBI-related mortality or improvement in overall outcome has been observed over the past 2 decades. 24 Recently, many studies have shown that the presence and frequency of high intracranial pressure (ICP) are predictive of the outcome of severe TBI. 18,23 Thus, ICP monitoring has been widely used in the management of severe TBI. Indeed, the Brain Trauma Foundation (BTF) guideabbreviatioNs BTF = Brain Trauma Foundation; GCS = Glasgow Coma Scale; ICP = intracranial pressure; ICU = intensive care unit; MD = mean difference; STROBE = Strengthening the Reporting of Observational Studies in Epidemiology; TBI = traumatic brain injury. submitted January 9, 2014. accepted October 22, 2014. iNclude wheN citiNg Published online December 5, 2014; DOI: 10.3171/2014.10.JNS1460. disclosure The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper. This work was supported by the National Natural Science Foundation of China (NSFC Grants 30371454, 81271375, and 81171133), the Science and Technology Commission of Shanghai Municipality Project (10JC1402300), and Shanghai Nature Science Foundation (08411952000). * Drs. Qiang Yuan, Xing Wu, and Yirui Sun contributed equally to this work. obJect Some studies have demonstrated that intracranial pressure (ICP) monitoring reduces the mortality of traumatic brain injury (TBI). But other studies have shown that ICP monitoring is associated with increased mortality. Thus, the authors performed a meta-analysis of studies comparing ICP monitoring with no ICP monitoring in patients who have suffered a TBI to determine if differences exist between these strategies with respect to mortality, intensive care unit (ICU) length of stay (LOS), and hospital LOS. methods The authors systematically searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (Central) from their inception to October 2013 for relevant studies. Randomized clinical trials and prospective cohort, retrospective observational cohort, and case-control studies that compared ICP monitoring with no ICP monitoring for the treatment of TBI were included in the analysis. Studies included had to report at least one point of mortality in an ICP monitoring group and a no-ICP monitoring group. Data were extracted for study characteristics, patient demographics, baseline characteristics, treatment details, and study outcomes. results A total of 14 studies including 24,792 patients were analyzed. The meta-analysis provides no evidence that ICP monitoring decreased the risk of death (pooled OR 0.93 [95% CI 0.77-1.11], p = 0.40). However, 7 of the studies including 12,944 patients were published after 2012 (January 2012 to October 2013), and they revealed that ICP monitoring was significantly associated with a greater decrease in mortality than no ICP monitoring (pooled OR 0.56 [95% CI 0.41-0.78...

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“…64 For trauma patients, the BEST:TRIP trial included adult TBI patients and failed to demonstrate the superiority of ICP monitoring over a protocol based on clinical examination and imaging. 65,66 In contrast, ICP-driven therapy in TBI has been associated with lower mortality in several studies. [67][68][69]…”

Section: Cerebral Oximetry and Perfusionmentioning

confidence: 99%

Management of the Pediatric Neurocritical Care Patient

2016

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Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury.

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Routine intracranial pressure monitoring in acute coma

Cited by 39 publications

References 42 publications

Invasive Meningococcal Disease in the Vaccine Era

Invasive Meningococcal Disease in the Vaccine Era

Impact of intracranial pressure monitoring on mortality in patients with traumatic brain injury: a systematic review and meta-analysis

Management of the Pediatric Neurocritical Care Patient

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