Department of Medicine, University of British Columbia, Canada.
Can J Neurol Sci. 2012 Sep;39(5):571-6. doi: 10.1017/s0317167100015286.
We conducted a systematic review to examine the relationship between intracranial pressure monitors (ICP) monitors and mortality in traumatic brain injury (TBI). We systematically searched for articles that met the following criteria: (1) adults patients, (2) TBI, (3) use of an ICP monitor, (4) point estimate for mortality with ICP monitoring (5) adjustment for potential confounders. Six observational studies were identified with 11,371 patients. There was marked between-study heterogeneity that precluded a pooled analysis. Patients with ICP monitors had different clinical characteristics and received more ICP targeted therapy in the ICU. Four studies found no significant relationship between ICP monitoring and survival, while the other two studies demonstrated conflicting results. Significant confounding by indication in observational studies limits the examination of isolated TBI interventions. More research should focus on interventions that affect TBI careplan systems. Further research is needed to identify which subset of severe TBI patients may benefit from ICP monitoring.
我们进行了一项系统评价，以研究颅内压监测（ICP）与创伤性脑损伤（TBI）患者死亡率之间的关系。我们系统地搜索了符合以下标准的文章：（1）成年患者，（2）TBI，（3）使用 ICP 监测器，（4）有 ICP 监测的死亡率点估计值，（5）调整潜在混杂因素。确定了六项观察性研究，涉及 11371 名患者。研究之间存在显著的异质性，因此无法进行汇总分析。使用 ICP 监测器的患者具有不同的临床特征，并在 ICU 中接受了更多的 ICP 靶向治疗。四项研究发现 ICP 监测与生存率之间没有显著关系，而另外两项研究则得出了相互矛盾的结果。观察性研究中存在明显的混杂因素，限制了对孤立性 TBI 干预措施的研究。应更多地关注影响 TBI 护理计划系统的干预措施。需要进一步研究以确定哪些严重 TBI 患者亚组可能受益于 ICP 监测。
