Intracranial pressure for clinicians: it is not just a number

BackgroundInvasive intracranial pressure (ICP) monitoring is a standard practice in severe brain injury cases, where it allows to derive cerebral perfusion pressure (CPP); ICP-tracing can also provide additional information about intracranial dynamics, forecast episodes of intracranial hypertension...

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Bibliographic Details
Published in:Journal of Anesthesia, Analgesia and Critical Care (Online) Analgesia and Critical Care (Online), 2023-09, Vol.3 (1), p.31-31, Article 31
Main Authors: Cucciolini, Giada, Motroni, Virginia, Czosnyka, Marek
Format: Article
Language:English
Subjects:
Artificial intelligence
Blood
Brain research
Cerebrospinal fluid
Edema
Hypertension
Intracranial pressure
Multimodality monitoring
Optimal CPP
Pathophysiology
Review
Sinuses
Spectral analysis
Traumatic brain injury
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Summary:BackgroundInvasive intracranial pressure (ICP) monitoring is a standard practice in severe brain injury cases, where it allows to derive cerebral perfusion pressure (CPP); ICP-tracing can also provide additional information about intracranial dynamics, forecast episodes of intracranial hypertension and set targets for a tailored therapy to prevent secondary brain injury. Nevertheless, controversies about the advantages of an ICP clinical management are still debated.FindingsThis article reviews recent research on ICP to improve the understanding of the topic and uncover the hidden information in this signal that may be useful in clinical practice. Parameters derived from time-domain as well as frequency domain analysis include compensatory reserve, autoregulation estimation, pulse waveform analysis, and behavior of ICP in time. The possibility to predict the outcome and apply a tailored therapy using a personalised perfusion pressure target is also described.ConclusionsICP is a crucial signal to monitor in severely brain injured patients; a bedside computer can empower standard monitoring giving new metrics that may aid in clinical management, establish a personalized therapy, and help to predict the outcome. Continuous collaboration between engineers and clinicians and application of new technologies to healthcare, is vital to improve the accuracy of current metrics and progress towards better care with individualized dynamic targets.
ISSN:2731-3786
2731-3786
DOI:10.1186/s44158-023-00115-5