Kirkness C J, Mitchell P H, Burr R L, March K S, Newell D W
Biobehavioral Nursing and Health Systems, University of Washington, Seattle 98195, USA.
J Neurosci Nurs. 2000 Oct;32(5):271-7. doi: 10.1097/01376517-200010000-00007.
Assessment of intracranial adaptive capacity is vital in critically ill individuals with acute brain injury because there is the potential that nursing care activities and environmental stimuli to result in clinically significant increases in intracranial pressure (ICP) in a subset of individuals with decreased intracranial adaptive capacity. ICP waveform analysis provides information about intracranial dynamics that can help identify individuals who have decreased adaptive capacity and are at risk for increases in ICP and decreases in cerebral perfusion pressure, which may contribute to secondary brain injury and have a negative impact on neurologic outcome. The ability to identify high-risk individuals allows nurses to initiate interventions targeted at decreasing adaptive demand or increasing adaptive capacity in these individuals. Changes in the ICP waveform occur under various physiologic and pathophysiologic conditions and may provide valuable information about intracranial adaptive capacity. Simple visual assessment of the ICP waveform for increased amplitude and P2 elevation is clinically relevant and has been found to provide a rough indicator of decreased adaptive capacity. Advanced ICP waveform analysis techniques warrant further study as a means of dynamically assessing intracranial adaptive capacity.
评估颅内适应能力对于急性脑损伤的危重症患者至关重要，因为对于一部分颅内适应能力下降的患者，护理活动和环境刺激有可能导致临床上显著的颅内压（ICP）升高。ICP波形分析提供了有关颅内动力学的信息，有助于识别那些适应能力下降、有ICP升高和脑灌注压降低风险的个体，这可能会导致继发性脑损伤并对神经学预后产生负面影响。识别高危个体的能力使护士能够针对这些个体启动旨在降低适应性需求或提高适应能力的干预措施。ICP波形在各种生理和病理生理条件下都会发生变化，可能会提供有关颅内适应能力的有价值信息。对ICP波形进行简单的视觉评估，观察其振幅增加和P2升高情况，在临床上具有相关性，并且已发现它能提供适应能力下降的粗略指标。先进的ICP波形分析技术作为动态评估颅内适应能力的一种手段，值得进一步研究。
