ArticleNeurocritical care2024
A Comprehensive Perspective on Intracranial Pressure Monitoring and Individualized Management in Neurocritical Care: Results of a Survey with Global Experts.
Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Utilization of Noninvasive Intracranial Pressure Monitoring in Patients with Traumatic Brain Injury Treated in Low-Resource Settings: The Intrigo Study.Neurocritical care · 2026Article
- Intracranial Pressure Estimation Using B4C Device: A Systematic Review on the Validation Studies.Neurocritical care · 2026Review
- Preliminary Evaluation of Preoperative Optic Nerve Sheath Diameter and CT Mass Effect in Relation to Pre-Excision Invasive Intracranial Pressure During Intracranial Tumor Surgery.Journal of clinical medicine · 2026Article
- Practicalities of noninvasive neuromonitoring in intensive care.Neurocritical care · 2026Article
- Personalized treatment approaches in neurocritical care.Acute and critical care · 2026Article
- Utility of intracranial pressure monitoring in idiopathic intracranial hypertension patients with refractory headaches: an 8-year, single-surgeon, specialized-center retrospective study.Neurosurgical focus · 2026Article
- Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.Neurocritical care · 2025Article
- Article
- Correlation of Different Non-Invasive Neuromonitoring Tools Assessing Intracranial Hemodynamics.Brain sciences · 2025Article
- Monro-Kellie 4.0: moving from intracranial pressure to intracranial dynamics.Critical care (London, England) · 2025Review
- Machine learning approach for noninvasive intracranial pressure estimation using pulsatile cranial expansion waveforms.NPJ digital medicine · 2025Article
- Managing Intracranial Pressure Crisis.Current neurology and neuroscience reports · 2024Review
- Global traumatic brain injury intracranial pressure: from monitoring to surgical decision.Frontiers in neurology · 2024Review
Corrections and comments
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Authors and funding
30 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNumerous trials have addressed intracranial pressure (ICP) management in neurocritical care. However, identifying its harmful thresholds and controlling ICP remain challenging in terms of improving outcomes. Evidence suggests that an individualized approach is necessary for establishing tolerance limits for ICP, incorporating factors such as ICP waveform (ICPW) or pulse morphology along with additional data provided by other invasive (e.g., brain oximetry) and noninvasive monitoring (NIM) methods (e.g., transcranial Doppler, optic nerve sheath diameter ultrasound, and pupillometry). This study aims to assess current ICP monitoring practices among experienced clinicians and explore whether guidelines should incorporate ancillary parameters from NIM and ICPW in future updates.
methodsWe conducted a survey among experienced professionals involved in researching and managing patients with severe injury across low-middle-income countries (LMICs) and high-income countries (HICs). We sought their insights on ICP monitoring, particularly focusing on the impact of NIM and ICPW in various clinical scenarios.
resultsFrom October to December 2023, 109 professionals from the Americas and Europe participated in the survey, evenly distributed between LMIC and HIC. When ICP ranged from 22 to 25 mm Hg, 62.3% of respondents were open to considering additional information, such as ICPW and other monitoring techniques, before adjusting therapy intensity levels. Moreover, 77% of respondents were inclined to reassess patients with ICP in the 18-22 mm Hg range, potentially escalating therapy intensity levels with the support of ICPW and NIM. Differences emerged between LMIC and HIC participants, with more LMIC respondents preferring arterial blood pressure transducer leveling at the heart and endorsing the use of NIM techniques and ICPW as ancillary information.
conclusionsExperienced clinicians tend to personalize ICP management, emphasizing the importance of considering various monitoring techniques. ICPW and noninvasive techniques, particularly in LMIC settings, warrant further exploration and could potentially enhance individualized patient care. The study suggests updating guidelines to include these additional components for a more personalized approach to ICP management.
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