Vrettou Charikleia S, Mentzelopoulos Spyros D
First Department of Intensive Care Medicine, Evaggelismos General Hospital, National and Kapodistrian University of Athens Medical School, 10676 Athens, Greece.
J Clin Med. 2022 Aug 16;11(16):4790. doi: 10.3390/jcm11164790.
Intracranial hypertension is a common finding in patients with severe traumatic brain injury. These patients need treatment in the intensive care unit, where intracranial pressure monitoring and, whenever possible, multimodal neuromonitoring can be applied. A three-tier approach is suggested in current recommendations, in which higher-tier therapies have more significant side effects. In this review, we explain the rationale for this approach, and analyze the benefits and risks of each therapeutic modality. Finally, we discuss, based on the most recent recommendations, how this approach can be adapted in low- and middle-income countries, where available resources are limited.
颅内高压是重型颅脑损伤患者的常见表现。这些患者需要在重症监护病房接受治疗，在该病房可进行颅内压监测，并且只要有可能，还可应用多模态神经监测。当前的推荐方案建议采用三级治疗方法，其中更高层级的治疗具有更显著的副作用。在本综述中，我们解释了这种治疗方法的基本原理，并分析了每种治疗方式的益处和风险。最后，我们根据最新的推荐方案，讨论在资源有限的低收入和中等收入国家如何调整这种治疗方法。
