Effect of different angle of head on intracranial pressure and cerebral perfusion pressure in patients with severe traumatic brain injury

Objective To investigate the effects of different angles of the head of bed on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with severe traumatic brain injury. Methods A prospective self-controlled study was used. The parameters of mean arterial pressure (MABP) and cerebral blood flow on 43 patients with STBI, were measured at 0°, 10°, 20° and 30° respectively. The changes of ICP and CPP were calculated according to the formula. Results With the angles of head of bed was up from 0°to 30°, MABP gradually reduced, (102.57±8.34) mmHg (1 mmHg= 0.133kPa), (100.74 ± 8.12) mmHg, (97.32 ± 7.94) mmHg, (94.82 ± 8.38) mmHg, so was ICP, which were (24.50±6.29) mmHg, (22.88±6.18) mmHg, (19.57±6.22) mmHg, (17.32±6.77) mmHg, and the difference was statistically significant (F=13.38, F=14.03, P 0.05). For moderate increased intracranial pressure patients (ICP 0.05). Conclusions Elevating the head to 30 °can rapidly reduce the intracranial pressure and ensure enough cerebral perfusion. It is a safe and effective treatment for the similar patients in emergency rescue and nursing. At the same time, for the patients with moderate intracranial hypertension (ICP ≥25 mmHg), elevation the head of bed up to 20 ° can reduce the adverse effects of intracranial pressure adaptability shortage and the cerebral hypoperfusion, increase the safety of nursing care, and reduce the secondary brain injuries. Key words: Posture; Traumatic brain injury; Intracranial pressure; Cerebral perfusion pressure