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Intracranial Pressure Monitors in Traumatic Brain Injury: A Systematic Review

Published online by Cambridge University Press:  02 December 2014

Asher A. Mendelson ,
Chris Gillis ,
William R. Henderson ,
Juan J. Ronco ,
Vinay Dhingra  and
Donald E. G. Griesdale
Asher A. Mendelson
Affiliation:
Department of Medicine, University of British Columbia and Department of Anesthesia, Vancouver General Hospital
Chris Gillis
Affiliation:
Deparment of Surgery, Division of Neurosurgery, University of British Columbia and Department of Anesthesia, Vancouver General Hospital
William R. Henderson
Affiliation:
Department of Medicine, University of British Columbia and Department of Anesthesia, Vancouver General Hospital Program of Critical Care Medicine, Vancouver General Hospital
Juan J. Ronco
Affiliation:
Department of Medicine, University of British Columbia and Department of Anesthesia, Vancouver General Hospital Program of Critical Care Medicine, Vancouver General Hospital
Vinay Dhingra
Affiliation:
Department of Medicine, University of British Columbia and Department of Anesthesia, Vancouver General Hospital Program of Critical Care Medicine, Vancouver General Hospital
Donald E. G. Griesdale*
Affiliation:
Department of Medicine, University of British Columbia and Department of Anesthesia, Vancouver General Hospital Department of Anesthesia, Pharmacology and Therapeutics, University of British Columbia and Department of Anesthesia, Vancouver General Hospital Program of Critical Care Medicine, Vancouver General Hospital Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
*
Department of Anesthesia & Program of Critical Care Medicine, Vancouver General Hospital Room 2438, Jim Pattison Pavilion, 2nd Floor 855 West 12th Avenue Vancouver, British Columbia, V5Z 1M9, Canada. Email: donald.griesdale@vch.ca
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Abstract

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We conducted a systematic review to examine the relationship between intracranial pressure monitors (ICP) monitors and mortality in traumatic brain injury (TBI). We systematically searched for articles that met the following criteria: (1) adults patients, (2) TBI, (3) use of an ICP monitor, (4) point estimate for mortality with ICP monitoring (5) adjustment for potential confounders. Six observational studies were identified with 11,371 patients. There was marked between-study heterogeneity that precluded a pooled analysis. Patients with ICP monitors had different clinical characteristics and received more ICP targeted therapy in the ICU. Four studies found no significant relationship between ICP monitoring and survival, while the other two studies demonstrated conflicting results. Significant confounding by indication in observational studies limits the examination of isolated TBI interventions. More research should focus on interventions that affect TBI careplan systems. Further research is needed to identify which subset of severe TBI patients may benefit from ICP monitoring.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 39 , Issue 5 , September 2012 , pp. 571 - 576
Copyright
Copyright © The Canadian Journal of Neurological 2012

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