Systematic review of decreased intracranial pressure with optimal head elevation in postcraniotomy patients: a meta‐analysis

Jiang, Yan; Ye, Zeng pan-pan; You, Chao; Hu, Xiuying; Liu, Yi; Li, Hao; Lin, Sen; Ji-pin, LI

doi:10.1111/jan.12679

Cited by 13 publications

(11 citation statements)

References 38 publications

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“…The maximal recorded increase in mean ICP (approximately +16.5 mm Hg/+180%) occurred after head down positioning in standing dogs (Figure , Table ) and likely reflects the higher potential for attaining a head position below the level of the heart compared to sternally positioned dogs. Optimal head elevation has been well documented to result in decreased ICP in human traumatic brain injury patients, although effect on clinical outcome is less defined . Large ICP variations with head position in our study in normal dogs similarly highlight the likely importance of this basic nursing component on ICP management in dogs with ICH.…”

Section: Discussionmentioning

confidence: 61%

Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain‐gauge transducers

Sturges

Dickinson

Tripp

et al. 2018

Veterinary Internal Medicne

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Background Monitoring of intracranial pressure (ICP) is a critical component in the management of intracranial hypertension. Safety, efficacy, and optimal location of microsensor devices have not been defined in dogs. Hypothesis/Objective Assessment of ICP using a microsensor transducer is feasible in anesthetized and conscious animals and is independent of transducer location. Intraparenchymal transducer placement is associated with more adverse effects. Animals Seven adult, bred‐for‐research dogs. Methods In a prospective investigational study, microsensor ICP transducers were inserted into subdural and intraparenchymal locations at defined rostral or caudal locations within the rostrotentorial compartment under general anesthesia. Mean arterial pressure and ICP were measured continuously during physiological maneuvers, and for 20 hours after anesthesia. Results Baseline mean ± SD values for ICP and cerebral perfusion pressure were 7.2 ± 2.3 and 78.9 ± 7.6 mm Hg, respectively. Catheter position did not have a significant effect on ICP measurements. There was significant variation from baseline ICP accompanying physiological maneuvers (P < .001) and with normal activities, especially with changes in head position (P < .001). Pathological sequelae were more evident after intraparenchymal versus subdural placement. Conclusions and Clinical Importance Use of a microsensor ICP transducer was technically straightforward and provided ICP measurements within previously reported reference ranges. Results support the use of an accessible dorsal location and subdural positioning. Transient fluctuations in ICP are normal events in conscious dogs and large variations associated with head position should be accounted for when evaluating animals with intracranial hypertension.

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Section: Discussionmentioning

confidence: 61%

Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain‐gauge transducers

Sturges

Dickinson

Tripp

et al. 2018

Veterinary Internal Medicne

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“…[13][14][15] However, these maneuvers are not be applicable to all patients because the Valsalva maneuver and the reverse Trendelenburg position may not be possible or disadvantageous in patients with hemodynamic instability or with altered mental status. [16][17][18] Our results indicate that a simple bed-side elevation of the lower back with the frog leg position maximizes the diameter and CSA of the FV, and this position will increase the accessibility of the FV. Overlapping of the FV by the FA can lead to inadvertent arterial catheterization or arteriovenous fistula.…”

Section: Discussionmentioning

confidence: 66%

“…13 –15 However, these maneuvers are not be applicable to all patients because the Valsalva maneuver and the reverse Trendelenburg position may not be possible or disadvantageous in patients with hemodynamic instability or with altered mental status. 16 –18…”

Section: Discussionmentioning

confidence: 99%

Novel body positioning maximizes femoral venous size in adults: An ultrasonographic evaluation

Ahn

Lee

Yoo

et al. 2018

Hong Kong j. emerg. med.

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Introduction: Increased femoral vein size may lead to a higher first pass success rate during central venous cannulation. The aim of this study was to evaluate the effects of body position on femoral vein anatomy for cannulation. Methods: This prospective study examined the femoral vein of healthy volunteers by ultrasound scanner. The changes in cross-sectional area and diameter of the femoral vein were evaluated. Right-sided measurements were taken at four different leg positions: neutral, frog leg, backup , and back-up/frog leg position. Results: A total of 50 subjects were enrolled in the study. The mean femoral vein cross-sectional area were 0.57 ± 0.29 cm 2 , 0.90 ± 0.26 cm 2 , 1.05 ± 0.33 cm 2 , and 1.47 ± 0.34 cm 2 , and the mean femoral vein diameter were 0.75 ± 0.20 cm, 1.05 ± 0.28 cm, 1.25 ± 0.21 cm, and 1.46 ± 0.25 cm in order of neutral, backup , frog leg, and back-up/frog leg position (p < 0.001). Conclusion: Performing the right femoral vein catheterization in backup and frog leg position is associated with a greater cross-sectional area of the femoral vein.

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“…Embora o único estudo que abordou o tema não tenha encontrado alteração estatisticamente significativa nos valores de PIC com a cabeceira em 15, 30 e 45 graus, assim como na posição supina, lateral direita e esquerda, o tamanho amostral de 30 pacientes foi considerado uma limitação da pesquisa (34). No entanto, outras pesquisas mostram que pacientes com aumento da PIC se beneficiam da elevação da cabeceira em 10, 15, 30 e 45 graus quando comparados a zero grau (45)(46).…”

Section: Discussionunclassified

Nursing Interventions for Patients with Intracranial Hypertension: Integrative Literature Review

2019

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Objective: the study sought to identify, in national and international publications, the principal Nursing interventions aimed at patients with intracranial hypertension. Materials and Method: integrative literature review with search in LILACS, PubMed, Scopus, Web of Science, Cinahal, and Google Scholar databases, from 2013 to 2018. Results: the sample was comprised of seven articles fulfilling the inclusion criteria. Two thematic categories were established for the Nursing interventions aimed at patients with intracranial hypertension: cognitive skills and clinical reasoning, necessary to control neuro-physiological parameters and prevent intracranial hypertension, and evidence-based practices to improve care for neuro-critical patients. Conclusions: intracranial hypertension is an event of great clinical impact, whose complications can be minimized and control through specific Nursing interventions that encompass control of neuro-physiological and hemodynamic parameters and prevention of increased intracranial pressure related with the performance of procedures by the Nursing staff.

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Systematic review of decreased intracranial pressure with optimal head elevation in postcraniotomy patients: a meta‐analysis

Cited by 13 publications

References 38 publications

Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain‐gauge transducers

Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain‐gauge transducers

Novel body positioning maximizes femoral venous size in adults: An ultrasonographic evaluation

Nursing Interventions for Patients with Intracranial Hypertension: Integrative Literature Review

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