Related Experiment Video
Updated: Sep 30, 2025
05:01
A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
7.1K
Where to Draw the Line for Intracranial Hypertension; Opening Pressures and Mortality
Jacob D Edwards1, Seth A Quinn1, Seth Saylors1
1Division of Trauma and Acute Care, Department of Surgery, The Brody School of Medicine, 12278East Carolina University, Greenville, NC, USA.
The American Surgeon
|March 11, 2022
Summary
Elevated intracranial opening pressure (OP) significantly predicts mortality in severe traumatic brain injury (TBI). Age and injury severity score also independently predict death, guiding TBI management decisions.
Area of Science:
- Neuroscience
- Trauma Surgery
- Critical Care Medicine
Background:
- Intracranial pressure (ICP) monitoring is crucial for severe traumatic brain injury (TBI) management.
- The direct relationship between intracranial opening pressure (OP) and patient outcomes remains incompletely understood.
Purpose of the Study:
- To investigate the association between intracranial opening pressure (OP) and outcomes in severe TBI patients.
- Specifically focusing on the impact of OP on in-hospital mortality rates.
Main Methods:
- Analysis of adult blunt TBI patients with ICP monitoring from 2007-2017.
- Utilized sequential multivariable binary logistic regression and generalized additive models (GAM).
- Calculated odds ratios (OR) and 95% confidence intervals (CI) to quantify associations.
Main Results:
- 182 patients were analyzed; 33.5% had OP >20 mmHg (mean OP 19.4 ± 17.8 mmHg).
- In-hospital mortality was 35%; 48% were discharged to rehabilitation.
- Elevated OP (OR=1.07), advanced age (OR=1.05), and higher Injury Severity Score (ISS) (OR=1.06) were independently associated with increased mortality risk.
Conclusions:
- High intracranial opening pressure is a strong predictor of mortality in severe TBI.
- Age and ISS are independent mortality predictors irrespective of OP.
- Lowering ICP may reduce mortality; age and ISS are vital in ICP management decisions.
Related Concept Videos
01:25Glaucoma: Overview
935
Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
935
01:27Open Angle Glaucoma: Treatment
728
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
728
01:24Pressure Relationships in Thoracic Cavity
3.4K
Breathing, otherwise known as pulmonary ventilation, is the process of air movement into and out of the lungs. The main mechanisms propelling pulmonary ventilation are atmospheric pressure (Patm), intra-pulmonary (Ppul ) or intra-alveolar pressure (Palv) within the alveoli, and intrapleural pressure (Pip) within the pleural cavity.
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs...
3.4K
01:24Blood Pressure
5.5K
The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
5.5K
01:28Hypertension I: Introduction
113
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
113
01:17Measurement of Blood Pressure
1.6K
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
1.6K