The physiology of ICP and CPP in neuro-critical settings Shoji YOKOBORI 1,2 1Department of Emergency Medicine Nippon Medical School 2Department of Critical Care Medicine Nippon Medical School pp.3-9
Published Date 2020/1/1
DOI https://doi.org/10.11477/mf.3102200703
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In neuro-critical care, patient management with monitoring of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is important. However, these pressure-based parameters have limitations because of pressure dysautoregulation of cerebral vessels after a severe brain injury. For example, with completely disrupted vascular autoregulation, a higher CPP may lead to ICP elevation. Therefore, additional advanced cerebral monitoring is needed for the treatment of brain-injured patients. The importance of head position and head elevation for the treatment of patients with intracranial hypertension is still a physiologic controversy. In this chapter, pathophysiological concerns and the treatment rationale for brain-injured patients are explained, with a discussion of clinical questions in the daily management of patients in the neuro-ICU.

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