1 / 24

INTRACRANIAL PRESSURE

INTRACRANIAL PRESSURE. Intracranial Pressure. Refers to the pressure contained within the cranial cavity . The normal range is between 0 to 15 mmHg. ICP over 20 mm/Hg is considered elevated ICP, also known as intracranial hypertension .

Jims
Download Presentation

INTRACRANIAL PRESSURE

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. INTRACRANIAL PRESSURE

  2. Intracranial Pressure • Refers to the pressure contained within the cranial cavity. • The normal range is between 0 to 15 mmHg. • ICP over 20 mm/Hg is considered elevated ICP, also known as intracranial hypertension. • The management team becomes concerned whenever a patient’s ICP is over 15 mm/Hg, but is especially concerned when it reaches levels of intracranial hypertension.

  3. Intracranial Pressure • Skull has three essential components: - Brain tissue = 78% - Blood = 12% - Cerebrospinal fluid (CSF) = 10% • Any increase in any of these tissues causes increased ICP

  4. Components of the Brain Fig. 55-1

  5. Factors that influence ICP • Arterial pressure • Venous pressure • Intraabdominal and intrathoracic pressure • Posture • Temperature • Blood gases (CO2 levels)

  6. Intracranial Pressure • The degree to which these factors  ICP depends on the ability of the brain to accommodate to the changes

  7. Regulation and Maintenance for ICP • If the volume in any one of the components (brain tissue, blood, and CSF) • increases within the cranial vault and the volume from another component is displaced, the total intracranial volume will not change

  8. Intracranial PressureRegulation and Maintenance • Normal compensatory adaptations • Alteration of CSF absorption or production • Shunting of CSF into spinal subarachnoid space • Shunting of venous blood out of the skull

  9. Mechanisms of Increased ICP • Causes • Mass lesion • Cerebral edema • Head injury • Brain inflammation • Metabolic insult

  10. Increased Intracranial PressureMechanisms of Increased ICP • Sustained increases in ICP result in brainstem compression and herniation of the brain from one compartment to another

  11. Increased Intracranial Pressure Fig. 55-3

  12. Herniation Fig. 55-4

  13. SITES FOR ICP MONITORINGEpiduralSubarachnoidIntraventricular

  14. ICP mentoring system

  15. ICP mentoring system

  16. Nursing Care: Assessment • Change in level of consciousness • Changes in vital signs (Cushing triad) • Widening pulse pressure • Tachy/Bradycardia • Increased systolic BP • Irregular respirations

  17. Nursing Care: Assessment • Ocular signs • Decrease in motor strength and function • Assess movement • Assess response to stimuli • Assess: • Decerebrate posturing (extensor) • Indicates more serious damage • Decorticate posturing (flexor)

  18. Decorticate and Decerebrate Posturing

  19. Nursing Care: Assessment • Headache • Often continuous and worse in the morning • Vomiting • Not preceded by nausea • Projectile

  20. Increased Intracranial PressureCollaborative Care • Hyperventilation therapy: suctioning → hyperventilate with 100% oxygen • Adequate oxygenation • PaO2 maintenance at 100 mm Hg or greater • ABG analysis guides the oxygen therapy • May require mechanical ventilator

  21. Increased Intracranial PressureCollaborative Care • Drug therapy • Mannitol • Loop diuretics • Corticosteroids • Barbiturates • Antiseizure drugs

  22. Increased Intracranial PressureCollaborative Care • Nutritional therapy • Patient is in hypermetabolic and hypercatabolic state •  Need for glucose • Keep patient normovolemic • IV 0.45% or 0.9% sodium chloride

  23. Increased Intracranial PressureNursing Management Overall goals: • ICP WNL • Maintain patent airway • Normal fluid and electrolyte balance • No complications secondary to immobility • Respiratory function • Fluid and electrolyte balance

  24. Increased Intracranial PressureNursing Management Overall goals (cont’d) • Body position maintained in head-up position: elevate HOB 30° • Protection from injury: positioning/turning • Pain control • Psychological considerations

More Related