Document Detail

Routine intracranial pressure monitoring in acute coma.
MedLine Citation:
PMID:  20166062     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Studies in traumatic encephalopathy first led to the insight that the damage seen was not just due to direct consequences of the primary injury. A significant, and potentially preventable, contribution to the overall morbidity arose from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) resulted in inadequate cerebral perfusion with well-oxygenated blood. Detection of raised ICP could be useful in alerting clinicians to the need to improve cerebral perfusion, with consequent reductions in brain injury.
OBJECTIVES: To determine whether routine ICP monitoring in all acute cases of severe coma reduces the risk of all-cause mortality or severe disability at final follow-up.
SEARCH STRATEGY: We searched the Cochrane Injuries Group's Specialised Register (searched 7 April 2009), CENTRAL (The Cochrane Library 2009, Issue 1), MEDLINE 1950 to March week 4 2009, EMBASE 1980 to week 14 March 2009, CINAHL 1982 to March 2009, ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED) 1970 to March 2009, Conference Proceedings Citation Index- Science (CPCI-S) 1990 to March 2009, PubMed (searched 7 April 2009, limit; added in last 6 months). The searches were last updated in April 2009.
SELECTION CRITERIA: All randomised controlled studies of real-time ICP monitoring by invasive or semi-invasive means in acute coma (traumatic or non-traumatic aetiology) versus no ICP monitoring (that is, clinical assessment of ICP).
DATA COLLECTION AND ANALYSIS: Primary outcome measures were all-cause mortality and severe disability at the end of the follow-up period.
MAIN RESULTS: No studies meeting the selection criteria have been identified to date.
AUTHORS' CONCLUSIONS: There are no data from randomised controlled trials that can clarify the role of ICP monitoring in acute coma.
Rob J Forsyth; Susanne Wolny; Beryl Rodrigues
Publication Detail:
Type:  Journal Article; Review     Date:  2010-02-17
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2010  
Date Detail:
Created Date:  2010-02-18     Completed Date:  2010-04-19     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD002043     Citation Subset:  IM    
Institute of Neuroscience, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, Tyne & Wear, UK, NE1 4LP.
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MeSH Terms
Acute Disease
Brain Injuries / complications
Cerebrovascular Circulation*
Coma / physiopathology*
Intracranial Hypertension / physiopathology*
Intracranial Pressure / physiology
Monitoring, Physiologic / methods
Update Of:
Cochrane Database Syst Rev. 2001;(3):CD002043   [PMID:  11687010 ]

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