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The effect of nursing interventions on the intracranial pressure in paediatric traumatic brain injury

Lyvonne N Tume1, Paul B Baines, Paulo J G Lisboa

  • 1PICU, Alder Hey Children's NHS Foundation Trust/Liverpool John Moores University, Liverpool, UK. lyvonne.tume@alderhey.nhs.uk

Nursing in Critical Care
|February 9, 2011
PubMed

Insights

Endotracheal suctioning and log-rolling interventions significantly increase intracranial pressure in pediatric traumatic brain injury patients. Other nursing care, like eye care or washing, did not affect ICP, especially after craniectomy.

Area of Science:

  • Pediatric Intensive Care
  • Neuroscience
  • Nursing Research

Background:

  • Limited evidence exists on the physiological impact of nursing interventions in pediatric intensive care.
  • This knowledge gap hinders the development of evidence-based practices for pediatric intensive care nursing.

Purpose of the Study:

  • To investigate the effects of five common nursing interventions on intracranial pressure (ICP) in children with moderate to severe traumatic brain injury (TBI).
  • To establish an evidence base for nursing practices in pediatric neurocritical care.

Main Methods:

  • A prospective observational cohort study was conducted over three years in a tertiary pediatric intensive care unit (PICU).
  • Five interventions were studied: endotracheal suctioning and manual ventilation (ETSMV), log-rolling (LR), eye care, oral care, and washing.
  • Data were collected within the first 72 hours post-injury in 25 children (aged 2-17) with ICP monitoring.

Main Results:

  • Endotracheal suctioning and manual ventilation (ETSMV) and log-rolling (LR) were associated with statistically significant increases in intracranial pressure (ICP).
  • Eye care, oral care, and washing did not result in clinically significant changes in ICP.
  • Following decompressive craniectomy, none of the studied nursing interventions caused significant changes in ICP.

Conclusions:

  • Endotracheal suctioning and log-rolling are interventions that can lead to intracranial hypertension in pediatric TBI patients.
  • Routine nursing care such as eye care, oral care, and washing appear safe concerning ICP levels.
  • This study contributes crucial evidence to pediatric neurocritical care, enabling nurses to optimize care for brain-injured children.
Abstract

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