Summary
Induced blood pressure elevation has become a popular treatment for intracranial hypertension. However, there remains a concern that in some patients blood pressure elevation will further elevate ICP. This study was conducted to test the hypothesis that increasing MAP decreases ICP. A total of 47 studies were performed on 23 intubated patients with head injury. MAP and Sjv02 were continuously monitored. MAP was raised significantly by 13.8 (5.9) mmHg (t-test; p < 0.0001) using phenylephrine infusion. The percent change ICP per mmHg increase in MAP (%ΔICP/mm Hg MAP) was calculated. Pearson correlation coefficient, t-test and logistic regression analysis were used for statistical evaluation. Increasing MAP resulted in a decrease in ICP in 38.3% and in an increase in ICP in 61.7% out of 47 studies. The following characteristics were seen in patients in whom a decrease in ICP was associated with an increase in MAP: High GCS (r = -0.61; p = 0.004) and low Sjv02 ((2 = 4.89; p = 0.027). In patients with lower GCS and high Sjv02 an increase in MAP resulted in an increase in ICP. We concluded that in the majority of studies increasing MAP was followed by an increase in ICP. CPP therapy has a selective indication in patients with high GCS, low Sjv02 and increased ICP.
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© 2002 Springer-Verlag
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Oertel, M., Kelly, D.F., Lee, J.H., Glenn, T.C., Vespa, P.M., Martin, N.A. (2002). Is CPP Therapy Beneficial for all Patients with High ICP?. In: Czosnyka, M., Pickard, J.D., Kirkpatrick, P.J., Smielewski, P., Hutchinson, P. (eds) Intracranial Pressure and Brain Biochemical Monitoring. Acta Neurochirurgica Supplements, vol 81. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6738-0_16
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DOI: https://doi.org/10.1007/978-3-7091-6738-0_16
Publisher Name: Springer, Vienna
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