doiSerbia

Prognostic significance of intracranial pressure monitoring and intracranial hypertension in severe brain trauma patients

Kostić Aleksandar (University Clinical Centre Niš, Department of Neurosurgery, Niš)
Stefanović Ivan (University Clinical Centre Niš, Department of Neurosurgery, Niš)
Novak Vesna (University Clinical Centre Niš, Department of Neurosurgery, Niš)
Veselinović Dragan (University Clinical Centre Niš, Department of Ophthalmology, Niš)
Ivanov Goran (University Clinical Centre Niš, Department of Anesthesiology, Niš)
Veselinović Aleksandar (University Clinical Centre Niš, Department of Ophthalmology, Niš)

Since without prospective randomized studies it is not possible to have a clear attitude towards the importance of intracranial pressure monitoring, this study was aimed at examining the prognostic effect of the intracranial pressure monitoring and intracranial pressure oriented therapy in severe brain trauma patients, and at defining optimal intracranial pressure values for starting the treatment. Two groups of patients were treated in the study, one consisted of 32 patients undergoing intracranial pressure monitoring and the second group of 29 patients without intracranial pressure monitoring in the control group. The study was prospective with groups randomized. There were 53% survivals in the intracranial pressure monitored patients and 34% in the control group, with no significant difference in the survival rate between the two groups (χ2=2.11; p=0.15; p>0.05). The average intracranial pressure in the patients with intracranial hypertension who died was 27 mm Hg, while in the patients who survived the average intracranial pressure was significantly lower (Student’s t test: t=2.91; p=0.008; p<0.01) and it was 18 mm Hg. We recommend starting intracranial pressure oriented therapy when the patient’s intracranial pressure exceeds 18 mmHg during 2 hours of monitoring.

Keywords: Intracranial Pressure + physiology, Intracranial Hypertension, Craniocerebral Trauma, Brain Injuries, Prognosis, Monitoring, Physiologic