ICU SAQs · Raised ICP & TBI
Cerebral perfusion pressure, autoregulation and the Monro-Kellie doctrine
A CICM First-Part basic-science question on the physiology underpinning raised-ICP management — the Monro-Kellie doctrine, the CPP equation, the cerebral autoregulation curve, and how each intracranial component and the PaCO2 affect the pressure.
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Prompt
Define cerebral perfusion pressure and explain its relationship to mean arterial pressure and intracranial pressure. Describe cerebral autoregulation and how it is altered by traumatic brain injury. State the Monro-Kellie doctrine and use it to explain how cerebral oedema, a haematoma and a rising PaCO2 each raise the intracranial pressure.
Question
Define cerebral perfusion pressure and explain its relationship to mean arterial pressure and intracranial pressure. Describe cerebral autoregulation and how it is altered by traumatic brain injury. State the Monro-Kellie doctrine and use it to explain how cerebral oedema, a haematoma and a rising PaCO2 each raise the intracranial pressure.
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.