ICP elevation is an important dimension of many neuroICU patients. Unfortunately, it remains unclear precisely who might benefit from ICP monitoring, or exactly what the optimal ICP targets should be.
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Josh is the creator of PulmCrit.org. He is an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
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Fantastic post! one comment I have..CPP will only improve with induced hypertension or vasopressor infusion in patients who are auto regulating. Patients who are not auto regulating , may even see a decrease in CPP because any increase in MAP will increase your ICP. Patients who suffer an acute brain injury may not be able to autoregulate (alter flow/ vessel diameter in response to changing maps over a limited range such that CPP remains constant) . Patients with a reliable continuous EVD monitor can be MAP challenge with a dose of vasopressor to test whether or not autoregulation is intact.… Read more »
CT can be used for ONSD to detect ICP elevation. Couple of studies out there. Easier to get than ultrasound if the CT was just done.
What setting would you recommend for a vent patient
Is there any data to support the use of hypertonic therapy for cerebral edema/impending herniation related to anoxic injury?
If you have herniation following anoxic injury maybe it’s better to let him/her go.