Intervention Review

Routine intracranial pressure monitoring in acute coma

  1. Rob J Forsyth1,*,
  2. Susanne Wolny2,
  3. Beryl Rodrigues3

Editorial Group: Cochrane Injuries Group

Published Online: 17 FEB 2010

Assessed as up-to-date: 31 MAR 2009

DOI: 10.1002/14651858.CD002043.pub2

Database Title

Additional Information

How to Cite

Forsyth RJ, Wolny S, Rodrigues B. Routine intracranial pressure monitoring in acute coma. Cochrane Database of Systematic Reviews 2010, Issue 2. Art. No.: CD002043. DOI: 10.1002/14651858.CD002043.pub2.

Author Information

  1. 1

    Newcastle University, Institute of Neuroscience, Newcastle upon Tyne, Tyne & Wear, UK

  2. 2

    NHS, Child Development Centre Royal Victoria Hospital, Newcastle upon Tyne, UK

  3. 3

    North Tyneside General Hospital, Department of Paediatrics, North Shields, UK

*Rob J Forsyth, Institute of Neuroscience, Newcastle University, Royal Victoria Infirmary, Newcastle upon Tyne, Tyne & Wear, NE1 4LP, UK. r.j.forsyth@newcastle.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 17 FEB 2010

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Studies in traumatic encephalopathy first led to the insight that the damage seen was not just due to direct consequences of the primary injury. A significant, and potentially preventable, contribution to the overall morbidity arose from secondary hypoxic-ischaemic damage. Brain swelling accompanied by raised intracranial pressure (ICP) resulted in inadequate cerebral perfusion with well-oxygenated blood. Detection of raised ICP could be useful in alerting clinicians to the need to improve cerebral perfusion, with consequent reductions in brain injury.

Objectives

To determine whether routine ICP monitoring in all acute cases of severe coma reduces the risk of all-cause mortality or severe disability at final follow-up.

Search methods

We searched the Cochrane Injuries Group's Specialised Register (searched 7 April 2009), CENTRAL (The Cochrane Library 2009, Issue 1), MEDLINE 1950 to March week 4 2009, EMBASE 1980 to week 14 March 2009, CINAHL 1982 to March 2009, ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED) 1970 to March 2009, Conference Proceedings Citation Index- Science (CPCI-S) 1990 to March 2009, PubMed (searched 7 April 2009, limit; added in last 6 months). The searches were last updated in April 2009.

Selection criteria

All randomised controlled studies of real-time ICP monitoring by invasive or semi-invasive means in acute coma (traumatic or non-traumatic aetiology) versus no ICP monitoring (that is, clinical assessment of ICP).

Data collection and analysis

Primary outcome measures were all-cause mortality and severe disability at the end of the follow-up period.

Main results

No studies meeting the selection criteria have been identified to date.

Authors' conclusions

There are no data from randomised controlled trials that can clarify the role of ICP monitoring in acute coma.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

No evidence from trials to show the effects of routine monitoring of intracranial pressure following head injury

The brain is situated in a rigid box (the skull) that cannot expand, so normal swelling from injury cannot occur. When brain swelling does occur, pressure inside the skull rises. This makes it harder for the heart to pump the oxygen and blood into the brain needed for recovery. If this swelling is not controlled, further brain damage is caused. Efforts to avoid this damage can include routine monitoring of the pressure inside the skull (intracranial). The review of trials found no evidence to show the effects of routine measurement of pressure in the skull. More research is needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

急性昏迷病人之常規顱內壓監測

外傷性腦病變的研究首次有了較明確的了解，損害似乎不只是因為最初的受傷而造成的直接後果。它是一種重要，且可能可以預防的，導因於續發之缺氧缺血性傷害造成的所有疾病。腦水腫伴隨著顱內壓(intracranial pressure (ICP))升高會造成腦部缺乏足夠的含氧血。偵測出ICP升高可能可以有效的警示醫師需要改善腦部血流灌注，以降低腦部受傷的後果。

目標

以最終追蹤結果是否能降低死亡率或嚴重失能的風險，決定是否需要對所有急性重度昏迷病人做常規顱內壓監測。

搜尋策略

我們檢索the Cochrane Injuries Group's專科的登記資料庫，CENTRAL，MEDLINE，EMBASE與Index of Scientific與Technical Proceedings。我們也確認所有相關文章的參考文獻。最後一次更新檢索是在2006年4月。

選擇標準

對於急性昏迷病患(外傷或非外傷的病因)以侵入性或半侵入性方式之即時ICP監測對照無ICP監測(即ICP的臨床評估)的所有隨機對照研究。

資料收集與分析

主要的測量結果為最終追蹤時之全死因死亡率與嚴重失能的狀況。

主要結論

至今沒有找到符合篩選標準的研究。

作者結論

沒有隨機對照試驗的資料可以清楚說明ICP監測對於急性昏迷病患的角色。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

尚待補充。

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