Document Detail


An approach to determining intracranial pressure variability capable of predicting decreased intracranial adaptive capacity in patients with traumatic brain injury.
MedLine Citation:
PMID:  20338894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jun-Yu Fan; Catherine Kirkness; Paolo Vicini; Robert Burr; Pamela Mitchell
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Biological research for nursing     Volume:  11     ISSN:  1552-4175     ISO Abbreviation:  Biol Res Nurs     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-07-12     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  9815758     Medline TA:  Biol Res Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  317-24     Citation Subset:  IM; N    
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological*
Adolescent
Adult
Brain Injuries / physiopathology*
Female
Humans
Intracranial Pressure*
Male
Middle Aged
Monitoring, Physiologic
Young Adult
Grant Support
ID/Acronym/Agency:
R01 NR004901/NR/NINR NIH HHS; R01 NR004901-07/NR/NINR NIH HHS; R01 NR04901/NR/NINR NIH HHS
Comments/Corrections

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