Refractory Increased Intracranial Pressure in Severe Traumatic Brain Injury
| Autor: | Richard Arbour, Mary Kay Bader, Sylvain Palmer |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Hypnosis medicine.medical_specialty Critical Care Leadership and Management medicine.drug_class Traumatic brain injury Sedation Nursing assessment Clinical Protocols Humans Hypnotics and Sedatives Medicine Intensive care medicine Pentobarbital Care Planning Nursing Assessment Intracranial pressure Neurologic Examination Advanced and Specialized Nursing Coma Evidence-Based Medicine Trauma Severity Indices Electromyography business.industry Patient Selection Decision Trees Electroencephalography Signal Processing Computer-Assisted General Medicine medicine.disease Treatment Outcome Barbiturate Brain Injuries Anesthesia Bispectral index Practice Guidelines as Topic Drug Monitoring Intracranial Hypertension medicine.symptom business Algorithms |
| Zdroj: | AACN Clinical Issues: Advanced Practice in Acute and Critical Care. 16:526-541 |
| ISSN: | 1079-0713 |
| DOI: | 10.1097/00044067-200510000-00009 |
| Popis: | Patients with severe traumatic brain injury resulting in increased intracranial pressure refractory to first-tier interventions challenge the critical care team. After exhausting these initial interventions, critical care practitioners may utilize barbiturate-induced coma in an attempt to reduce the intracranial pressure. Titrating appropriate levels of barbiturate is imperative. Underdosing the drug may fail to control the intracranial pressure, whereas overdosing may lead to untoward effects such as hypotension and cardiac compromise. Monitoring for a therapeutic level of barbiturate coma includes targeting drug levels and using continuous electroencephalogram monitoring, considered the gold standard. New technology, the Bispectral Index monitor, utilizes electroencephalogram principles to monitor the level of sedation and hypnosis in the critical care environment. This technology is now being considered for targeting appropriate levels of barbiturate coma. |
| Databáze: | OpenAIRE |
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