Intracranial hypertension at severe traumatic brain injury: diagnostics and prognosis results

Abstract

Introduction. Intracranial hypertension (ICH) is a main reason of death and disability in traumatic brain injury (TBI) patients.Study objective is to determine intracranial pressure (ICP) parameters that presumably influence final treatment outcome.Materials and methods. The results of a prospective study of 100 injured persons in the acute phase of heavy TBI in 2006–2011 have been analyzed. ICP measuring was carried out using parenchymal sensors on Spielberg’s (Germany) Brain Pressure Monitor REF HDM 26.1/FV500. The total of 11,657 hours of ICP monitoring were recorded.ROC–analysis was used for selecting the most informative ICH parameter. The dependence of treatment outcome on five basic ICP parameters (ICH dosage, duration, and manifesting, mean and maximum ICP) in two patient groups (survived/died and favorable/unfavorable outcome) has been studied.Results. Patient groups with two different treatment outcomes differ most definitely by parameters that characterize ICH manifesting.Mean ICP for predicting the “survived/died” outcome on the basis of ROC–analysis data was 16.9 mm Hg, and for determining favorable/unfavorable treatment outcome, 16.48 mm Hg.Conclusions. Thus, mean ICP of 16.5 mm Hg shall be assumed as a new therapeutic endpoint.