Objective: To determine the diurnal variations of intracranial pressure in head injured patients.
Methods: The BrainIT group have collected high resolution physiological and clinical data from head injured patients who require intracranial pressure monitoring. Minute by minute measurements of ICP and BP were made. Validated data from 200 patients recruited to the BrainIT study were used for an analysis to examine the diurnal variations in ICP in head injured patients cared for in ITU.
Results: This study has identified a very small (<1 mm of Hg) temporal trend in the ICP values in cases without raised ICP (<=20mmHg). In cases with ICP rise (>20mmHg) a diurnal variation of up to 3mmHg was noted. The peaks of ICP rise occurred at 0900, 1600 and 2100 hours and these peaks of ICP rise were also associated with a simultaneous rise in MAP and CPP.
Conclusions: Based on ICP measurements in 200 severely head injured patients, we found that there was a diurnal rhythm in ICP thought this was small being no more than 3mmHg and only seen in cases with ICP elevated over 20mmHg.
Chambers IR, Rodrigues D, Mukerji N, Gregson BA, Piper I, Mitchell P on behalf of the BrainIT Group. Diurnal variations of ICP in severely head injured patients. International Symposium on Intracranial Pressure and Brain Monitoring, Mechanisms and Treatment. 23rd July 2007, San Francisco.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.
Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
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