Management and Effects of Therapies to Reduce Intracranial Pressure in Patients Victims of Severe Traumatic Brain Injury
Abstract
Traumatic brain injury (TBI) is one of the medical emergencies with high morbidity and
mortality, and is the leading cause of death in young adult patients. Primary injuries caused by
trauma are found, but the primary goal is to prevent secondary brain injury, which is caused by
elevated intracranial pressure (ICP). The objective of this review was to determine possible
management and effects on reducing ICP in patients with severe TBI. A search for previous
articles was carried out on the PubMed and Regional Portal of the Virtual Health Library (VHL)
platforms. The study included articles published in the last 5 years (2019-2024); controlled
clinical trials and observational studies and available free of charge. Articles that deviated from
the topic addressed and duplicates were excluded. At the end of the analysis, 17 scientific
articles were selected. The studies analyzed showed that ICP monitoring with non-conventional
devices, or through cerebral oxygenation pressure, partial pressure of carbon dioxide and
treatment with hypertonic saline or mannitol were the most effective in reducing ICP. Although
there are divergences regarding the intervention of elevated ICP, there is evidence that when it
is controlled, it changes the patient's prognosis, assuming an important role in clinical practice.
In conclusion, the most effective interventions were the use of partial pressure of carbon
dioxide, hypertonic saline and mannitol and early monitoring of cerebral oxygenation by
cerebral oxygenation pressure (PbtO2), emphasizing the need for ICP monitoring in order to
reduce mortality.
Keywords: Severe Traumatic Brain Injury; Intracranial Pressure; Management.
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Copyright (c) 2025 Anna Victória Coelho Andrade Delgado Fonseca, Vitor Moreira Alvarenga
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