Podcast # 484: Elevated ICP
Release Date: 07/04/2019
Contributor: Charleen Gnisci, PharmD
- Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma.
- While definite treatment is to remove the offending cause, there are emergency medicine
- Non-pharmacologic methods include elevating head of bed and removing noxious stimuli
- Pharmacologic options include mannitol and hypertonic saline
- Hypertonic saline is best delivered through a central line but not required
- Both these agents benefit from adequate renal function
- Before using mannitol, be sure to inspect the bag to ensure that it has not precipitated. If it has, try warming the bag before administration.
Burgess S, Abu-Laban RB, Slavik RS, Vu EN, Zed PJ. A Systematic Review of Randomized Controlled Trials Comparing Hypertonic Sodium Solutions and Mannitol for Traumatic Brain Injury: Implications for Emergency Department Management. Ann Pharmacother. 2016 Apr;50(4):291-300. doi: 10.1177/1060028016628893. Epub 2016 Jan 29. Review. PubMed PMID: 26825644.
Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD