Management of raised ICP are all except:-
Correct Answer: Hypercapnia
Description: Stepwise approach to treatment of Elevated Intracranial Pressure Inse ICP monitor - ventriculostomy or parenchymal device General goals: maintain ICP < 20 mmHg and CPP 60 mmHg For ICP > 20-25 mmHg for > 5 min: - elevated head of the bed, midline head position - osmotherapy - mannitol - Sedation (e.g. morphine, propofol, or midazolam); add neuromuscular paralysis, if necessary (patient will require endotracheal intubation and mechanical ventilation at this [point, if not before) - hyperventilation - to PaCO2 30-35 mmHg - pressor therapy - phenylephrine, dopamine, or norepinephrine to maintain adequate MAP to ensure CPP 60 mmHg Consider second-tier therapies for refractory elevated ICP: High dose barbiturate therapy ("Pentobarb coma") Aggressive hyperventilation to PaCO2 < 30 mmHg Hypothermia Hemicraniectomy
Category:
Surgery
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