Clinical application of invasive intracranial pressure monitoring after severe traumatic brain injury

Abstract

Objective The current study aims to investigate the effects of different intracranial pressure(ICP) monitoring means on the prognosis of severe traumatic brain injury,and to determine the significance of all kinds of intracranial pressure monitoring methods for treating severe traumatic brain injury clinically.Methods From January 2009 to June 2010,a total of 201 cases of severe traumatic brain injury(STBI) who received operation treatment were collected and divided into A,B,and C groups based on the positions of the ICP probes and the placement methods.ICP monitoring probes were placed in the ventricle of the brain,parenchyma,or under the putamen,on the basis of the routine operation.Lumbar puncture was done once a day for three to seven days after operation.The Ncurolymph pressure and ICP value that are simultaneously shown in the ICP monitoring device were recorded to calculate the difference between them and to conduct comparison among the groups.The corresponding dehydration treatment was made based on the ICP value after operation to record the duration of use and dosage of the dehydrating agent,operation time,occurrence of all kinds of complications,and the prognosis of patients,and to create a comparison among the groups.Results The different values between the ICP monitoring values and ncurolymph pressure in the A,B,and C groups were 22.4±3.6,20.8±4.1,and 12.3±11.5 mmH2O,respectively. The dosage and durationof use of mannitol in group C were significantly higher than those in groups A and B(P < 0.01),whereas the incidence of pulmonary infection and electrolyte disturbance in group C was higher than those in groups A and B(P < 0.01).However,no significant difference of prognosis was observed among the three groups.The operating duration of group A was significantly longer than those of groups B and C(P < 0.01).However,the overall prognosis of the patients in the three groups had no significant difference.The operation time of group A was longer than that of groups B and C(P < 0.01),whereas the operation time of groups B and C had no significant difference.Conclusion The ICP value obtained through continuous invasive ICP monitoring is more stable,which makes it an important means for treating STBI.In addition,placing probes in the parenchyma is an effective monitoring method.