Traumatic Intracranial Hypertension
Nino Stocchetti, M.D., and Andrew I.R. Maas, M.D., Ph.D.
N Engl J Med 2014;370:2121-30. PMID: 24869722
This review article by Stocchetti et al on Traumatic Intracranial Hypertension takes us through the main mechanisms causing increased intracranial pressure and the recommendations for ICP monitoring in traumatic brain injury with its accompanied risks and benefits.
The causes of raised ICP and their possible therapeutic approach are individualised and a simple algorithm for treatment of raised ICP is given which is easy to follow. An excellent graphical representation of the staircase approach to the treatment of increased ICP accompanied by the risks of therapy and levels evidence for each treatment method accompany the article. The jury is still out for the need for intracranial pressure monitoring. How many of you would be brave enough to go without any form of monitoring? I am not sure I am.
This is another must read for Intensive Care trainees.
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