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Prepeared By Dr: Manal Moussa

Intracranial Pressure Monitoring. Prepeared By Dr: Manal Moussa. Intracranial Pressure Monitoring. Definition: pressure exerted by intracranial volume of: 1- Brain 2- Blood 3- CSF Normal ICP: 1 - 15 mm Hg. Increased ICP: >20 mm Hg.

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Prepeared By Dr: Manal Moussa

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  1. Intracranial Pressure Monitoring Prepeared By Dr: Manal Moussa

  2. Intracranial Pressure Monitoring • Definition: pressure exerted by intracranial volume of: • 1- Brain • 2- Blood • 3- CSF • Normal ICP: 1 - 15 mm Hg. • Increased ICP: >20 mm Hg.

  3. - Understanding the Determinants of Intracranial Pressure - • Intracranial Contents: • 1- 80% brain tissue • 2- 10% blood • 3- 10% cerebrospinal fluid • An increase in the volume of any of these intracranial contents causes increased intracranial pressure • - The brain can swell (edema) • - Excess blood can accumulate due to hemorrhage • - Cerebrospinal fluid can accumulate due to blockage of outflow

  4. Causes of Sustained Increases in ICP Increased Brain Volume Increased CSF Increased blood volume cerebral edema from trauma or hypoxia, infectious process, tumor decrease fluid absorption due to meningitis, obstruction of CSF flow due to hydrocephalus or tumor aneurysm, intracranial hemorrhage

  5. Measuring Intracranial Pressure Procedure: Indication: To measure ICP, which allows for calculation of cerebral perfusion pressure (CPP). CPP is an important indicator of cerebral blood flow. ICP monitoring may be useful in patients with sever head injury. Normal range of CPP : 60 - 70

  6. ICP Review • CBF is a factor of CPP • If CPP , then CBF  • CPP = Mean arterial pressure (MAP) - ICP • MAP = systolic BP+2 (Diastolic ) divided on 3.

  7. EXAMPLECEREBRAL PERFUSION PRESSURE (CPP) The following assessment is made: BP = 130/82; ICP=15; MAP = 98 MAP- ICP = CPP 98 -15= 83 (>60 indicates the brain is being perfused) MAP <50 - >100 and/or ICP >20 impairs cerebral perfusion

  8. SITES FOR ICP MONITORINGEpiduralSubarachnoidIntraventricular

  9. Equipment: - Hair clippers. - Antiseptic solution. - Sterile drapes and towels. - No. 11 scalpel. - Local anesthetic. - 10-ml syringe, 18, 25, and 27-G needles for local anesthesia (optional). - Twist drill. - Nonbacteriostatic saline.

  10. - 3-ml syringe. - Three-way stopcock. - Analgesics and sedatives as prescribed. -ICP monitoring system options: Fiberoptic system, Sensor system, Transducer. - Monitor calibrated with ICP monitoring setup. - Suture, needle holder, scissors. - Topical antibiotics. - Sterile occlusive dressing.

  11. Nursing Care: 1- Maintaining a patent airway 2- Achieving an adequate breathing pattern 3- Optimizing cerebral tissue perfusion 4- Maintaining negative fluid balance 5- Preventing infection 6- Monitoring and managing potential complications

  12. THANK YOU

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