RobbaandCiterioCriticalCare()23:
HowImanageintracranialhypertension
ChiaraRobba1andGiuseppeCiterio2,3*
WhyandwhentomanageintracranialhypertensionThedetrimentaleffectsofintracranialhypertension(HICP,highintracranialpressure)arewelldocumented.HICPcancausesecondarybraininjuryanddeath,andtherefore,intracranialpressure(ICP)elevationsshouldbeaggressivelytreated.颅内高压(HICP，高颅内压)的有害影响众所周知[1,2]。HICP可引起继发性脑损伤甚至死亡，因此颅内压升高应积极处理。
HICPhasbeenclassicallydefinedasanICP20mmHg,andthisthresholdhasbeenconsideredthetriggerfortreatment.RecentBTFguidelineshavemovedthisthresholdto22mmHg,groundedonasingle-centre,retrospectivestudy.Thismodificationistrivial.Asformanyothertreatmentoptionsinintensivecare,asinglethresholdisdebatable.Infact,recentevidencesuggeststhatnotasinglevaluebutthetimespentoverthethresholdanditsintensity,theso-calledICPdose,ismoreimportant.Moreover,Guizademonstratedthatnotonlyhighervaluesbutalsoprolongedexposuretovaluesbelowtheclassicalthresholdareassociatedwithnegativeout