Table 3.
ICP management strategies that were employed in the included studies
| Study ID | Was ICP managed? | Goal of ICP management | ICP vs. CPP-targeted management protocol | Management strategies | Indications for invasive procedures | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mannitol | Hyperventilation | Thiopental and sedation | Hypothermia | Lund concept | Invasive procedures | Invasive techniques used | |||||
| Winkler [16] | Yes (in 2/3) | NM | ICP-targeted | Yes | Yes | Yes | Yes | No | Yes | EVD | Clinical signs of cerebral herniation in the form of neurologic deterioration |
| Lindvall [4] | Yes (in 13/15) | ICP: < 20 mm Hg | ICP and CPP-targeted | No | No | No | No | Yes | Yes | EVD IPM | In case an acute drop in ICP was deemed necessary |
| Odetola [32] | Yes | NM | Unclear | No | No | No | No | No | Yes | EVD | In case of elevated ICP |
| Bruun [28] | Yes | NM | ICP-targeted | Yes | Yes | No | No | No | Yes |
LD, IPM DC |
High ICP for LD For DC: after radiological diagnosis of subdural effusion with associated neurological deterioration |
| Edberg [29] | Yes |
ICP: ≤ 20 mm Hg CPP: > 60 mm Hg |
ICP-targeted | No | Yes | Yes | No | No | Yes |
EVD IPM DC |
For EVD: In case of elevated ICP For DC: In case of elevated ICP despite previous treatment attempts |
| Abulhasan [31] | Yes | NM | ICP-targeted | No | No | No | No | No | Yes | LD | In case of severe neurological deficits or deterioration and elevated ICP despite previous treatment attempts |
| Kumar [27] | Yes |
ICP group: ICP > 20 mm Hg CPP group: CPP ≥ 60 mm Hg |
Group 1: ICP-targeted Group 2: CPP-targeted |
Yes | Yes | Yes | No | No | Yes | IPM | In case of elevated ICP |
| Muralidharan [26] | Yes | NM | Unclear | No | No | No | No | No | Yes |
EVD IPM |
In case of elevated ICP |
| Glimåker [9] | Yes |
ICP: < 20 mm Hg CPP: > 50 mm Hg |
ICP-targeted | Yes | Yes | Yes | Yes | No | Yes |
EVD IPM |
In case of elevated ICP |
| Kumar [30] | Yes | NM | ICP-targeted | No | No | No | No | No | Yes |
EVD VP shunt |
In case of elevated ICP |
| Depreitere [17] | Yes | To treat associated hydrocephalus | ICP-targeted | No | No | Yes | No | No | Yes |
EVD DC |
For both EVD and DC: In case of elevated ICP |
| Larsen [25] | Yes (in 29/39) |
ICP: < 20 mm Hg CPP: > 60 mm Hg |
ICP and CPP-targeted | Yes | Yes | Yes | No | No | Yes |
EVD IPM LD |
In case of elevated ICP |
| Johansson K. (2020) | Yes | NM | Unclear | No | No | No | No | No | Yes |
EVD IPM |
In case of elevated ICP |
| Wettervik [24] | Yes |
ICP: ≤ 20 mm Hg CPP: ≥ 60 mm Hg |
ICP and CPP-targeted | No | Yes | Yes | No | No | Yes |
EVD IPM DC |
For EVD: In case of elevated ICP For DC: In case of elevated ICP despite previous treatment attempts |
| Rebaud [34] | Yes |
ICP: < 15 mm Hg CPP: > 40 mm Hg |
ICP-targeted | No | Yes | Yes | No | No | No | Subdural catheter | Comatose patients |
| Grände (2002) | Yes | ICP: < 25–30 mm Hg | ICP and CPP-targeted | No | No | No | No | Yes | No | EVD | In case of elevated ICP |
| Odetola [42] | Unclear | NM | Unclear | N/a | N/a | N/a | N/a | N/a | N/a | EVD | In case of elevated ICP |
| Shetty [33] | Yes |
CPP: > 70 mm Hg in children > 2 y. of age and > 60 mm Hg in children < 2 y |
ICP and CPP-targeted | Yes | No | No | No | No | No | IPM | In case of elevated ICP |
CPP: cerebral perfusion pressure, CSF: cerebrospinal fluid, DC: decompressive craniotomy, EVD: external ventricular drain, ICP: intracranial pressure, ID: identifier, IPM: intraparenchymal monitor, LD: lumbar drain, N/a: not applicable, NM: not mentioned, VP shunt: ventriculoperitoneal shunt