Syed Shahrul Naz Profile picture
Feb 22 β€’ 5 tweets β€’ 6 min read
🧠 Intracranial pressure (ICP): current perspectives on physiology and monitoring 🧠 #FOAMcc #NeuroCritCare #FOAMed #EMCCM #NeuroICU #NeruroMonitoring #IntensiveCare #CriticalCare #MedEd πŸ“– Intensive Care Med (2022) 48:1471–1481
πŸ“– doi.org/10.1007/s00134… ImageImageImageImage
βœ… 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
βœ… 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
βœ… It facilitates the calculation of cerebral perfusion pressure (CPP) and the estimation of cerebrovascular autoregulatory status. *CPP = MAP - ICP* #FOAMcc #NeuroCritCare
Take home message:
#FOAMcc #NeuroCritCare Image

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More from @drshahrul80

Feb 22
β€œTen tips to optimize #vasopressors use in the critically ill patient with #hypotension.” #IntensiveCare #MedTwitter #CardioTwitter #sepsis #FOAMed #FOAMcc #CriticalCare #EmergencyMedicine #PedsICU #ICU #EMCCM
πŸ“š Intensive Care Med (2022) 48:736–739 rdcu.be/c57Se
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.
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