Why elevate head of bed 30 degrees ICP

• Prospective, observational study in 37 adult patients with coma due to severe intracranial lesions.

• The effect of 0o, 15o, 30o and 45o head elevation on CBF, CPP, ICP and arteriovenous pressure gradient were studied. The angles were measured using a goniometer

• All patients were mechanically ventilated, sedated and paralyzed. The mean Glasgow coma scale was 6 (range 3-11).

• CBF was measured using the thermodilution method.

• ICP was measured by catheter inserted into the frontal horn of the lateral ventricle

• Jugular catheters were inserted ipsilaterally into the vein on the side of the unilateral hemispheric lesion or on the right side in case of bihemispheric lesions.

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[Correction of intracranial hypertension syndrome using hyperosmolar solutions in patients with severe brain damage (multicenter randomized clinical study)].

Polushin IuS, Krylov VV, Svistov DV, Belkin AA, Petrikov SS, Shchegolev AV, Leĭderman IN, Shatalov VI, Alasheev AM, Golikov MV, Guseĭnova KhT, Rudnik EN, Soldatov AS, Solodov AA, Titova IuV. Polushin IuS, et al. Anesteziol Reanimatol. 2009 Sep-Oct;(5):4-8. Anesteziol Reanimatol. 2009. PMID: 20491142 Clinical Trial. Russian.