Cerebrovascular status and Trendelenburg position in severe head injury

The literature review revealed increasing sophistication of neuroscience nursing research since 1978. Conclusions of the papers reviewed have contributed to the acceptance as "fact" that nursing actions may increase ICP, but few have systematically studied effects upon cerebral perfusion pressure, the more critical variable. McQuillan's study (11) has examined the conflict between the goals of respiratory care and those of maintaining adequate cerebral perfusion, concluding that an intervention often discouraged for use with this patient group may in fact offer hope for reduction of complications. The methodology and results suggest that repeating the study would be both feasible and ethical.