Editorial: Intracranial pressure monitoring for brain injury

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Zeng and colleagues examine the impact of treatment based on monitored intracranial pressure (ICP) versus that delivered without monitoring on both 6-month neurologic outcome (Glasgow Outcome Scale score) and renal function.5 They report significantly better recovery and less renal dysfunction in monitored patients managed in accordance with the Brain Trauma Foundation guidelines.

Unfortunately, these authors do not present data sufficient to support their claim of improved outcome. Neither do they securely establish that ICP monitoring would be associated with less renal failure if this study were repeated elsewhere.

Patients were parsed into monitored versus non-monitored groups according to

Article Information

Please include this information when citing this paper: published online August 2, 2013; DOI: 10.3171/2013.5.JNS13254.

© AANS, except where prohibited by US copyright law.

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References

1

Chesnut RMTemkin NCarney NDikmen SRondina CVidetta W: A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:247124812012

2

International Society of Nephrology: KDIGO Clinical Practice Guideline for Acute Kidney Injury. KI Supplements 2:March2012. (http://www.kdigo.org/clinical_practice_guidelines/pdf/KDIGO%20AKI%20Guideline.pdf) [Accessed July 3 2013]

3

Lewington AKanagasundaram S: Renal Association Clinical Practice Guidelines on acute kidney injury. Nephron Clin Pract 118:Suppl 1c349c3902011

4

Marklund NHillered L: Animal modelling of traumatic brain injury in preclinical drug development: where do we go from here?. Br J Pharmacol 164:120712292011

5

Zeng JTong WZheng P: Decreased risk of acute kidney injury with intracranial pressure monitoring in patients with moderate or severe brain injury. Clinical article. J Neurosurg [epub ahead of print August 2 2013. DOI: 10.3171/2013.7.JNS122131]

1

Corral LJavierre CFVentura JLMarcos PHerrero JIMañez R: Impact of non-neurological complications in severe traumatic brain injury outcome. Crit Care 16:R442012

2

Cremer OL: Does ICP monitoring make a difference in neurocritical care?. Eur J Anaesthesiol Suppl 42:87932008

3

Cremer OLvan Dijk GWvan Wensen EBrekelmans GJFMoons KGMLeenen LPH: Effect of intracranial pressure monitoring and targeted intensive care on functional outcome after severe head injury. Crit Care Med 33:220722132005

4

Lane PLSkoretz TGDoig GGirotti MJ: Intracranial pressure monitoring and outcomes after traumatic brain injury. Can J Surg 43:4424482000

5

Lewington AKanagasundaram S: Renal Association Clinical Practice Guidelines on acute kidney injury. Nephron Clin Pract 118:Suppl 1c349c3902011

6

Mauritz WSteltzer HBauer PDolanski-Aghamanoukjan LMetnitz P: Monitoring of intracranial pressure in patients with severe traumatic brain injury: an Austrian prospective multicenter study. Intensive Care Med 34:120812152008

7

Shafi SDiaz-Arrastia RMadden CGentilello L: Intracranial pressure monitoring in brain-injured patients is associated with worsening of survival. J Trauma 64:3353402008

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