Neuroprotection in critical illness
A generic approach - relevant to managing a suspected or known raised ICP in a intubated and ventilated patient
breathing
- normoxia
- normocarbia (4.5 - 5.0)
- low PEEP
circulation
- normotension
- SBP >90 or MAP 80-85
- CPP 50-70
disability
- propofol infusion
- opiate infusion ? - reduce spikes in ICP during airway suction/in response to pian
exposure
- remove collar
- head up
- avoid tight tube ties
- avoid hyperthermia
- is there a role for seizure prophylaxis??