Effect of different angle of head on intracranial pressure and cerebral perfusion pressure in patients with severe traumatic brain injury
10.3760/cma.j.issn.1672-7088.2016.35.006
- VernacularTitle:不同角度头高位对重型颅脑损伤患者颅内压及脑灌注压的影响
- Author:
Lin LU
;
Xinjuan DAI
;
Min YANG
- Keywords:
Posture;
Traumatic brain injury;
Intracranial pressure;
Cerebral perfusion pressure
- From:
Chinese Journal of Practical Nursing
2016;32(35):2742-2745
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of different angles of the head of bed on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with severe traumatic brain injury. Methods A prospective self-controlled study was used. The parameters of mean arterial pressure (MABP) and cerebral blood flow on 43 patients with STBI, were measured at 0° , 10° , 20° and 30° respectively. The changes of ICP and CPP were calculated according to the formula. Results With the angles of head of bed was up from 0° to 30° , MABP gradually reduced, (102.57 ± 8.34) mmHg (1 mmHg=0.133kPa), (100.74 ± 8.12) mmHg, (97.32 ± 7.94) mmHg, (94.82 ± 8.38) mmHg, so was ICP, which were (24.50 ± 6.29) mmHg, (22.88 ± 6.18) mmHg, (19.57 ± 6.22) mmHg, (17.32 ± 6.77) mmHg, and the difference was statistically significant(F=13.38,F=14.03,P<0.01). CPP reduced slightly, (78.03 ± 5.47) mmHg, (77.86 ± 5.50) mmHg, (77.75 ± 5.61) mmHg, (75.51 ± 5.76) mmHg, but the difference was not statistically significant(F=2.09,P>0.05). For moderate increased intracranial pressure patients (ICP< 25 mmHg), when the angles of head of bed up to 20° , ICP decreased gradually to(27.46 ± 5.20)mmHg and the difference was statistically significant (F=5.97,P <0.05), however,CPP did not change significantly, which was(77.50±5.35)mmHg (F=5.03,P>0.05). Conclusions Elevating the head to 30 °can rapidly reduce the intracranial pressure and ensure enough cerebral perfusion. It is a safe and effective treatment for the similar patients in emergency rescue and nursing. At the same time, for the patients with moderate intracranial hypertension (ICP ≥25 mmHg), elevation the head of bed up to 20 ° can reduce the adverse effects of intracranial pressure adaptability shortage and the cerebral hypoperfusion, increase the safety of nursing care, and reduce the secondary brain injuries.
