Changes in intracranial pressure associated with chest physiotherapy
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Updated: Jul 14, 2026

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
DaiWai M Olson1, Suzanne M Thoyre, Dennis A Turner
1The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. dmolson@email.unc.edu
Introduction:
Management of intracranial hypertension is pivotal in the care of brain-injured patients.
Summary Of Case:
We report the case of a patient with both a closed head injury and anoxic encephalopathy, who subsequently experienced episodes of refractory intracranial hypertension. The patient's care was complicated by the development of a pneumonia, which required frequent turning of the patient and chest physiotherapy. Conventional wisdom suggests that these interventions may stimulate the patient and worsen intracranial pressure, and therefore should be avoided.
Results:
Our observations on this patient, however, contradict this belief. This single-subject study presents data to support the use of chest physiotherapy in patients at risk for intracranial hypertension.
Conclusions:
Further, the evidence is compelling that a randomized-controlled trial is indicated to test the hypothesis that chest physiotherapy may actually result in short-term resolution of high intracranial pressure, and thus provide one more clinical tool in the management of elevated intracranial pressure.
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