Management of increased intracranial pressure in the critically ill child with an acute neurological injury.

Abstract

Increased intracranial pressure reflects the presence of mass effect in the brain and is associated with a poor outcome in children with acute neurological injury. If sustained, it has a negative effect on cerebral blood flow and cerebral perfusion pressure, can cause direct compression of vital cerebral structures, and can lead to herniation. The management of the patient with increased intracranial pressure involves the maintenance of an adequate cerebral perfusion pressure, prevention of intracranial hypertension, and optimization of oxygen delivery. This article reviews the neurological assessment, pathophysiology, and management of increased intracranial pressure in the critically ill child who has sustained an acute neurological injury.

• Authors: Kelly Keefe Marcoux
• Journal: AACN clinical issues (AACN Clin Issues) 2005 Apr-Jun Vol. 16 Issue 2 Pg. 212-31; quiz 270-1 ISSN: 1079-0713 [Print] United States
• PMID: 15876889 (Publication Type: Journal Article, Review)

Chemical References

• Diuretics, Osmotic
• Mannitol

Topics

• Acute Disease
• Algorithms
• Brain (physiology, physiopathology)
• Brain Injuries (complications)
• Child
• Conscious Sedation (methods, nursing)
• Cranial Nerves (physiology, physiopathology)
• Critical Care (methods)
• Decision Trees
• Diuretics, Osmotic (therapeutic use)
• Fluid Therapy (methods, nursing)
• Glasgow Coma Scale
• Humans
• Infant
• Intracranial Hypertension (etiology, physiopathology, therapy)
• Mannitol (therapeutic use)
• Monitoring, Physiologic (methods, nursing)
• Neurologic Examination (methods, nursing)
• Nurse's Role
• Nursing Assessment
• Pediatric Nursing (methods)
• Posture
• Reflex, Pupillary (physiology)
• Respiration, Artificial (methods, nursing)