ArticleJournal of intensive care medicine2026
Neuromuscular Blockade for Intracranial Hypertension: Quantifying Real-World Effectiveness on Intracranial Pressure.
Article in Journal of intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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Abstract
BackgroundContemporary intracranial hypertension guidelines, including SIBICC (2019) and the 2024 ACS Best Practices, list neuromuscular blockade as a Tier Two, short-duration option for refractory ICP elevation. Despite its physiologic rationale, the real-world effect of initiating continuous paralysis on ICP has not been quantified using large-scale intra-patient physiologic data.MethodsWe performed a retrospective intra-patient before-after study at a Level 1 trauma and neurocritical care center (2016-2021). Among 9373 ICU admissions, 106 patients receiving a Rocuronium infusion with continuous invasive ICP monitoring met inclusion criteria. ICP values were compared using symmetric pre/post windows (-165-0 min; +15-180 min). A generalized additive model (GAM) evaluated time-dependent ICP changes adjusting for sedatives and hypertonic saline.ResultsMedian ICP decreased from 20.7 to 18.6 mm Hg (within-patient Δ -0.9 mm Hg;
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