This systematic review and meta-analysis examined the optimal degree of head elevation to decrease intracranial pressure in postcraniotomy patients. The analysis included 237 patients from studies dating from 1960 to 2014. Head elevations of 10, 15, 30 and 45 degrees were compared. The results showed that intracranial pressure was lower at all degrees of elevation compared to 0 degrees. A head elevation of 30 degrees was found to be optimal, with intracranial pressure not significantly different from 45 degrees but lower than at 10 and 15 degrees. The conclusion was that 30-45 degrees of head elevation is most effective at decreasing intracranial pressure for postcraniotomy patients.
This systematic review and meta-analysis examined the optimal degree of head elevation to decrease intracranial pressure in postcraniotomy patients. The analysis included 237 patients from studies dating from 1960 to 2014. Head elevations of 10, 15, 30 and 45 degrees were compared. The results showed that intracranial pressure was lower at all degrees of elevation compared to 0 degrees. A head elevation of 30 degrees was found to be optimal, with intracranial pressure not significantly different from 45 degrees but lower than at 10 and 15 degrees. The conclusion was that 30-45 degrees of head elevation is most effective at decreasing intracranial pressure for postcraniotomy patients.
This systematic review and meta-analysis examined the optimal degree of head elevation to decrease intracranial pressure in postcraniotomy patients. The analysis included 237 patients from studies dating from 1960 to 2014. Head elevations of 10, 15, 30 and 45 degrees were compared. The results showed that intracranial pressure was lower at all degrees of elevation compared to 0 degrees. A head elevation of 30 degrees was found to be optimal, with intracranial pressure not significantly different from 45 degrees but lower than at 10 and 15 degrees. The conclusion was that 30-45 degrees of head elevation is most effective at decreasing intracranial pressure for postcraniotomy patients.
intracranial pressure with optimal head elevation in postcraniotomy patients: a meta-analysis Researchers
JIANG Y. , YE Z.P . - P . , YOU C. , HU X . , LIU Y . ,
LI H. , LIN S . & L I J . - P Published
March, 27 2015 Background
Intracranial pressure (ICP) is pressure inside
the skull and ICP in brain tissue or cerebrospinal fluid is normally 7-15 mmHg in a supine adult. Craniotomies are surgical operations, which involveremoving a bone flap from the skull and are performed on patients suffering from traumatic brain injury (TBI), Parkinson’s disease, epilepsy and cerebellar tremor. Tankisi and Cold (2007) determined that the optimal degree of elevation in most patients is 15 degrees when in the reverse Trendelenburg position; however, Winkelman (2000) found that ICP can be improved significantly and clinically when patients with increased ICP are elevated to 30 degrees. There is no metaanalysis published concerning the optimal degree that decreases ICP in postcraniotomy patients. Many former articles suggested a change in head positioncan lead to a change in intracranial pressure; however, there are conflicting data regarding the optimal degree that decreases intracranial pressure in postcraniotomy patients. The Aim
To determine an optimal head elevation
degree to decrease intracranial pressure in postcraniotomy patients by meta-analysis Place and time of research China, Dating from 1960 until January 2014 Sampling
The total number of cases included in this study
was 237 Instrument
Systematic review Intervention
Head elevation of 10, 15, 30 and 45 degrees
Data Analyzed
Data were analysed with Review Manage
Version 5.0.24 (RevMan 5.0.24) software, which was downloaded from the Cochrane Library. We regarded P < 005 as statistically significant. Result These included a total of 237 participants who were included in the meta-analysis. 1. Compared with 0 degree: 10, 15, 30 and 45 degrees of head elevation resulted in lower intracranial pressure. 2. Intracranial pressure at 30 degrees was not significantly different in comparison to 45 degrees and was lower than that at 10 and 15 degrees. Conclusion
Patients with increased intracranial pressure
significantly benefitted from a head elevation of 10, 15, 30 and 45 degrees compared with 0 degrees. A head elevation of 30 or 45 degrees is optimal for decreasing intracranial pressure.