Godoy Daniel Agustín, Videtta Walter, Di Napoli Mario
Intensive Care Unit, San Juan Bautista Hospital, Catamarca, Argentina; Neurointensive Care Unit, Sanatorio Pasteur, Chacabuco 675, Catamarca 4700, Argentina.
Intensive Care Unit, National Hospital, Alejandro Posadas, Buenos Aires, Argentina; Intensive Care Unit, Eva Peron Hospital, Merlo, Buenos Aires, Argentina.
Neurol Clin. 2017 Nov;35(4):613-640. doi: 10.1016/j.ncl.2017.06.002.
Intracranial hypertension is one of leading causes of mortality after acute brain injury. Its causes and origins are multiple. The approach should be based on the underlying pathophysiology. There are different therapeutic modalities to control increased intracranial pressure (ICP), but all share the objective of normalizing basic physiologic variables. ICP control should be combined with adequate cerebral perfusion pressure. The classic approach to ICP control is unidirectional and sequential escalation of therapy. The nonresponse to classic therapy signaled a refractory condition. Multimodal monitoring has emerged as a useful tool, taking into account the analysis of ICP, oxygenation, and cerebral metabolism.
颅内高压是急性脑损伤后主要的死亡原因之一。其病因和起源多种多样。治疗方法应基于潜在的病理生理学。有不同的治疗方式来控制颅内压（ICP）升高，但所有这些方法都有使基本生理变量正常化的目标。ICP控制应与足够的脑灌注压相结合。经典的ICP控制方法是单向且逐步升级的治疗。对经典治疗无反应表明病情难治。多模态监测已成为一种有用的工具，它考虑了对ICP、氧合和脑代谢的分析。
