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An Approach to Determining Intracranial Pressure Variability Capable of Predicting Decreased Intracranial Adaptive Capacity in Patients With Traumatic Brain Injury
- Source :
- Biological Research For Nursing. 11:317-324
- Publication Year :
- 2010
- Publisher :
- SAGE Publications, 2010.
-
Abstract
- Nurses caring for traumatic brain injury (TBI) patients with intracranial hypertension (ICH) recognize that patients whose intracranial adaptive capacity is reduced are susceptible to periods of disproportionate increase in intracranial pressure (DIICP) in response to a variety of stimuli. It is possible that DIICP signals potential secondary brain damage due to sustained or intermittent ICH. However, there are few clinically accessible intracranial pressure (ICP) measurement parameters that allow nurses and other critical care clinicians to identify patients at risk of DIICP. The purpose of this study was to investigate whether there are specific minute-to-minute trends in ICP variability during the first 48 hr of monitoring that might accurately predict DIICP in patients with severe TBI. A total of 38 patients with severe TBI were sampled from the data set of a randomized controlled trial testing bedside monitoring displays and cerebral perfusion pressure management in individuals with TBI or sub-arachnoid hemorrhage. The investigators retrospectively examined the rates of change (slope) in mean, standard deviation, and variance of ICP on a 1-min basis for 30 consecutive min prior to a specified DIICP event. There was a significantly increasing linear and quadratic slope in mean ICP prior to the development of DIICP, compared with the comparison data set (p < .05). It is feasible to display moving averages in modern bedside monitoring. Such an arrangement may be useful to provide visual displays that provide immediate clinically relevant information regarding the patients with decreased adaptive capacity and therefore increased risk of DIICP.
- Subjects :
- Adult
Male
Adolescent
Intracranial Pressure
Traumatic brain injury
Brain damage
Article
law.invention
Young Adult
Text mining
Randomized controlled trial
law
Humans
Medicine
Young adult
Cerebral perfusion pressure
Monitoring, Physiologic
Intracranial pressure
Research and Theory
business.industry
Middle Aged
medicine.disease
Adaptation, Physiological
nervous system diseases
Decreased intracranial adaptive capacity
Brain Injuries
Anesthesia
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 15524175 and 10998004
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- Biological Research For Nursing
- Accession number :
- edsair.doi.dedup.....0a8c5930a5ffd0ab6ce09d0590cd1a41