Increased intracranial pressure reflects the presence of mass effect in the brain and is associated with a poor outcome in children with acute neurological injury. If sustained, it has a negative effect on cerebral blood flow and cerebral perfusion pressure, can cause direct compression of vital cerebral structures, and can lead to herniation. The management of the patient with increased intracranial pressure involves the maintenance of an adequate cerebral perfusion pressure, prevention of intracranial hypertension, and optimization of oxygen delivery. This article reviews the neurological assessment, pathophysiology, and management of increased intracranial pressure in the critically ill child who has sustained an acute neurological injury.
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Pediatrics| April 01 2005
Management of Increased Intracranial Pressure in the Critically Ill Child With an Acute Neurological Injury
Kelly Keefe Marcoux, MSN, CPNP-AC, CCRN
From the Robert Wood Johnson Medical School, University of Medicine & Dentistry of New Jersey, Piscataway, and the Bristol-Myers Squibb Children’s Hospital, New Brunswick, NJ.
Reprint requests to Kelly Keefe Marcoux, Clinical Assistant Professor, 26 Covered Bridge Road, Neshanic Station, NJ 08853 (firstname.lastname@example.org)
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AACN Adv Crit Care (2005) 16 (2): 212–231.
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Kelly Keefe Marcoux; Management of Increased Intracranial Pressure in the Critically Ill Child With an Acute Neurological Injury. AACN Adv Crit Care 1 April 2005; 16 (2): 212–231. doi:
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