β ICP monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. #FOAMcc#NeurocritCare
β It serves to warn of expanding intracranial mass lesions, to prevent or treat herniation events as well as pressure elevation which impedes nutrient delivery to the brain. #FOAMcc#NeuroCritCare
β It facilitates the calculation of cerebral perfusion pressure (CPP) and the estimation of cerebrovascular autoregulatory status. *CPP = MAP - ICP* #FOAMcc#NeuroCritCare
1. Set goals of mean or diastolic blood pressures. 2. Individualize the arterial pressure targets goals. 3. Vasopressors induce an endogenous fluid recruitment and may limit positive fluid balance. 4. Reassess fluid status and cardiac output after initiation of vasopressors
5. Consider agents with a different mechanism of action as a second line agent. 6. Consider adding hydrocortisone in patients on high doses of vasopressors. 7. Vasopressin is an option in patients with right ventricular failure. 8. There is no maximal dose of vasopressors.