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Abstract：
Increased intracranial pressure (ICP) is frequently encountered in the neurosurgical setting. A multitude of tactics exists to reduce ICP, ranging from patient position and medications to cerebrospinal fluid diversion and surgical decompression. A vast amount of literature has been published regarding ICP management in the critical care setting, but studies specifically tailored toward the management of intraoperative acute increases in ICP or brain bulk are lacking. Compartmentalizing the intracranial space into blood, brain tissue, and cerebrospinal fluid and understanding the numerous techniques available to affect these individual compartments can guide the surgical team to quickly identify increased brain bulk and respond appropriately. Rapidly instituting measures for brain relaxation in the operating room is essential in optimizing patient outcomes. Knowledge of the efficacy, rapidity, feasibility, and risks of the various available interventions can aid the team to properly tailor their approach to each individual patient. In this article, we present the first evidence-based review of intraoperative management of ICP and brain bulk.
摘要：
在神经外科手术中经常遇到颅内压（ICP）升高。存在许多减少ICP的策略，从病人的位置和药物到脑脊液分流和手术减压。已经发表了大量关于重症监护环境中ICP管理的文献，但目前还缺乏专门针对术中ICP或脑体积急性升高的治疗而进行的研究.将颅内空间划分为血液，脑组织,和脑脊液以及了解影响这些单独隔室的众多技术可以指导手术团队快速识别增加的大脑体积并做出适当的反应。在手术室中快速制定大脑放松措施对于优化患者预后至关重要。了解功效，快速性,可行性,和风险的各种可用的干预措施可以帮助团队适当地调整他们的方法为每个病人。在这篇文章中,我们对ICP和脑体积的术中管理进行了首次循证综述.
