Monitoring and management of intracranial pressure in pediatric severe traumatic brain injury / 中国小儿急救医学

ABSTRACT

Continuous intracranial hypertension in patients with severe traumatic brain injury(sTBI) is the key factor of secondary brain injury.The management of elevated intracranial pressure (ICP) can improve the outcome.ICP monitoring methods are divided into invasive and non-invasive.Non-invasive monitoring has not yet reached a level of sufficient accuracy for treatment decisions in clinical practice as invasive monitoring.The gold standard to measure ICP is through an external ventricular drain coupled to an external fluid-filled transducer measurement.The treatment strategy of sTBI is stratified.It can be divided into baseline care, first tier therapies and second tier therapies according to the difficulty of management and treatment risk.The therapeutic targets are mitigating intracranial hypertension, optimizing cerebral perfusion and oxygenation, and preventing or reversing cerebral herniation.From the baseline care, sTBI patients gradually upgrade the therapies until the targets are achieved, so to improve the outcomes of sTBI children.