Professional Documents
Culture Documents
Option
• Effective doses range from 0.25 - 1.0 gm/kg
body weight.
Mannitol
Option
• The indications for the use of mannitol prior to ICP
monitoring are signs of transtentorial herniation or
progressive neurological deterioration not
attributable to systemic pathology.
• However, hypovolemia should be avoided by
fluid replacement.
Barbiturates
Guideline
• High-dose barbiturate therapy may be considered
in hemodynamically stable salvagable severe head
injury patients with intracranial hypertension
refractory to maximal medical and surgical ICP
lowering therapy.
• A prospective trial of 73 patients with severe head injury and
medically refractory intracranial hypertension, randomized to
receive either a regimen including high-dose pentobarbital or
similar regiment without pentobarbital.
• Refractory intracranial hypertension occurred in only 12%
of the original severe head injury group (925 Patients).
• The chance of survival for those patients whose ICP
decreased(ICP < 20 mm Hg) with barbiturate treatment
was 92% compared to 17% when it did not.