Management of a Sustained Rise in Intracranial Pressure - Flowchart
Management of a Sustained Rise in Intracranial Pressure - Flowchart Hepatic Encephalopathy Hepatic Encephalopathy
«Flowchart»

Sustained rise in ICP >25 mm Hg (5 min or more)

Sustained rise in ICP >25 mm Hg (5 min or more)

Sustained rise in ICP >25 mm Hg (5 min or more)

Mannitol 100 mL of 20% or 0.5 g/kg

Mannitol 100 mL of 20% or 0.5 g/kg

Mannitol 100 mL of 20% or 0.5 g/kg

20-mL bolus of 30% saline

20-mL bolus of 30% saline

20-mL bolus of 30% saline

Attempt to maintain CPP >40 mm Hg with fluids and vasopressor

Attempt to maintain CPP >40 mm Hg with fluids and vasopressor

Attempt to maintain CPP >40 mm Hg with fluids and vasopressor

Thiopentone bolus (125 mg)

Thiopentone bolus (125 mg)

Thiopentone bolus (125 mg)

End

End

End

Evidence of luxury perfusion and increased cerebral blood volume

Evidence of luxury perfusion and increased cerebral blood volume

Evidence of luxury perfusion and increased cerebral blood volume

Hyperventilation (monitor JV Sats)

Hyperventilation (monitor JV Sats)

Hyperventilation (monitor JV Sats)

Indomethacin 25 mg

Indomethacin 25 mg

Indomethacin 25 mg

CPP, cerebral perfusion pressure; ICP, intracranial pressure; JV, jugular venous; Sats, saturation.

CPP, cerebral perfusion pressure; ICP, intracranial pressure; JV, jugular venous; Sats, saturation.

CPP, cerebral perfusion pressure; ICP, intracranial pressure; JV, jugular venous; Sats, saturation.

CPP ICP JV Sats

Consider

Consider

Consider

Hypothermia

Hypothermia

Hypothermia

Increase sedation with propofol

Increase sedation with propofol

Increase sedation with propofol

Is the JV sat >80%?

Is the JV sat >80%?

Is the JV sat >80%?