Factors Affecting Intracranial Pressure and Nursing Interventions
Published on: 2015-05-27
Intracranial pressure is the amount of pressure that the cranium exerts on brain tissue, the brain's blood volume and cerebrospinal fluid. Accosrding to Monro-Kellie hypothesis, the body has various mechanisms with the ability to keep the intracranial pressure stable by changing the volume of one of the cranial constituents (blood, cerebrospinal fluid, and brain tissue). When these compensatory mechanisms fail to maintain normal balance, intracranial pressure begins to rise. In neurosurgical patients, many factors such as hypercapnia, hypoxemia, endotracheal aspiration, valsalva maneuver, noxious stimuli and activities increasing cerebral metabolism affect intracranial pressure. The interventions applied in the care of a neurosurgical patient mainly focus on determining the frequency of observations, detecting early signs and symptoms of increased intracranial pressure, administering the appropriate treatment and care in a timely manner, preventing herniation and thus reducing the risk of morbidity and mortality. Nurses providing care for neurosurgical patients should be well aware of the factors affecting intracranial pressure, care interventions to prevent intracranial pressure increase, as well as a thorough understanding of the early signs of increased intracranial pressure. They should also be capable of both planning and implementing specific individual care interventions. This review is designed to identify the factors affecting intracranial pressure and explain the mechanism of increased intracranial pressure with an emphasis on the current literature, which will serve as a guide for neurosurgical nurses in planning the proper nursing care for these patients in line with the current clinical practice guidelines and recommendations.