Factors affecting intracranial pressure: a descriptive study

Area of Science:

• Neurology
• Critical Care Nursing
• Trauma Management

Background:

• Severe head injuries often lead to elevated intracranial pressure (ICP).
• Monitoring and managing ICP is critical for improving outcomes in patients with severe head trauma.
• Understanding factors that influence ICP is essential for effective patient care.

Purpose of the Study:

• To investigate the impact of various occurrences on intracranial pressure (ICP) in patients with severe head injuries.
• To identify specific healthcare activities, patient-initiated actions, and environmental stimuli that affect ICP.
• To provide evidence-based recommendations for nursing care to manage ICP.

Main Methods:

• Observational study involving four patients with severe head injuries (Glasgow Coma Score < 5).
• Monitored intracranial pressure (ICP) during 365 distinct occurrences.
• Categorized occurrences into healthcare activities, patient-initiated activities, and environmental stimuli.

Main Results:

• Healthcare activities like suctioning, turning, and head flexion increased ICP.
• Patient-initiated activities such as extremity flexion, neck rotation, and coughing elevated ICP.
• Elevating the head of the bed and repositioning patients decreased ICP.
• Environmental stimuli did not consistently affect ICP; bathing was found to increase it.

Conclusions:

• Nursing care modifications, including slower turning and proper head/neck positioning, can help manage ICP.
• Direct psychosocial support for families is recommended for patients with low Glasgow Coma Scores.
• Further research is needed to fully elucidate the complex interplay between patient activities and ICP.