Cerebral perfusion pressure management of severe diffuse head injury: effect on brain compliance and intracranial pressure.

Simple item page
dc.contributor.authorPillai, Sen_US
dc.contributor.authorPraharaj, S Sen_US
dc.contributor.authorRao, G S Uen_US
dc.contributor.authorKolluri, V R Sen_US
dc.date.accessioned2004-03-08en_US
dc.date.accessioned2009-06-03T12:41:35Z
dc.date.available2004-03-08en_US
dc.date.available2009-06-03T12:41:35Z
dc.date.issued2004-03-08en_US
dc.description.abstractBACKGROUND: Cerebral perfusion pressure management (CPPM) is an accepted modality of treatment of severe diffuse head injury (SDHI). However, CPPM has the potential to cause transcapillary exudation in the presence of a disrupted blood brain barrier and can lead to further increase of intracranial pressure (ICP) and worsening of compliance. AIMS: This study attempts to evaluate the effect of both transient and prolonged changes in cerebral perfusion pressure (CPP) on ICP and cerebral compliance as measured by the Pressure Volume Index (PVI), and to correlate changes in PVI with outcome at 12 months using the Glasgow Outcome Score. SETTINGS AND DESIGN: Prospective study in a neurosurgical ICU. MATERIAL AND METHODS: Twenty-seven SDHI patients managed using standard protocol to maintain CPP above 70 mmHg. Mean arterial pressure (MAP), ICP and CPP were monitored every half-hour. Daily monitoring of the PVI and ICP was done before, and after the induced elevation of MAP using IV Dopamine infusion. The relationship between CPP, MAP, ICP, PVI and outcome was evaluated. STATISTICAL ANALYSIS USED: The paired and independent samples T-test, and the Pearson correlation coefficient. RESULTS: CPPM rarely leads to progressive rise in ICP. Maintaining CPP above 70mmHg does not influence ICP or PVI. Transient elevations in CPP above 70mmHg may produce a small rise in ICP. Trend of change in PVI influenced outcome despite similar ICP and CPP. CONCLUSION: Elevating the CPP above 70mmHg does not either reduce the ICP or worsen the compliance. Monitoring changes in compliance should form an integral part of CPPM.en_US
dc.description.affiliationDepartment of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India. drshibupillai@hotmail.comen_US
dc.identifier.citationPillai S, Praharaj SS, Rao GS, Kolluri VR. Cerebral perfusion pressure management of severe diffuse head injury: effect on brain compliance and intracranial pressure. Neurology India. 2004 Mar; 52(1): 67-71en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/121721
dc.language.isoengen_US
dc.source.urihttps://neurologyindia.comen_US
dc.subject.meshAdulten_US
dc.subject.meshBlood Pressure --physiologyen_US
dc.subject.meshBrain --physiopathologyen_US
dc.subject.meshCerebrovascular Circulation --physiologyen_US
dc.subject.meshComplianceen_US
dc.subject.meshFemaleen_US
dc.subject.meshGlasgow Outcome Scaleen_US
dc.subject.meshHead Injuries, Closed --physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshIntracranial Pressure --physiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleCerebral perfusion pressure management of severe diffuse head injury: effect on brain compliance and intracranial pressure.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
Files
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.79 KB
Format:
Plain Text
Description:
Download
Collections
Neurology India