Sample Essay
The basic aim of management in patients with raised ICP is to maintain adequate blood supply to the brain, to prevent or minimize secondary injury to the neurons and intracranial structures and to keep the ICP within normal limits. The goal is to maintain ICP less than 20 mmHg and cerebral perfusion pressure of more than 70 mmHg (AK Chaudhary, 2005).
Initially, the airway is secured and most of the patients with raised ICP require tracheal intubation. A frequent check is done to ensure the patency of the endotracheal tube avoiding excessive suction as this can lead to further increases in ICP. Propofol is the ideal drug used for neuroanesthesia (AK Chaudhary, 2005).
The head is kept in an elevated position (15-30 degrees). Adequate hydration is provided to patients using isotonic fluids, in order to maintain cerebral blood flow. Temperature regulating mechanisms are also disrupted in the body due to brain injury and ischemia. Therefore, it is important to aggressively manage fever as it can increase the metabolic rate and hence, oxygen demand of brain cells.
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