Slide 1

ICP monitoring in TBI ISso last seasonJohn A Myburgh

Sydney

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P (mmHg)V (ml)

1783, 1824 Alexander Monro1733-1817

George Kellie1720-1779

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Rat / human model 20th century

Take a young male rat.Infuse alcohol or ice until intoxicated.Throw rat at high speed into brick wallBreak its femur and pelvis.Leave it lying in the corner for 1 hour.Get resident to resuscitate it using albumin and ketamineInclude an oesophageal intubation and hypoxia for 20m.Get orthopod to fix femur and lose 20% blood volume.Do a CT head, but dont tell the researcher the results.Get a resident to put in ICP monitor 6-36 hours after injury.Do the intervention.Random use of mannitol, hyperventilation, hypothermia, barbs

Count how many rats are dead after 1 week.

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Rat / human model 21th century

Take a rat of any age.If young, infuse alcohol or speed until intoxicated.If old, give warfarin and aspirinEarly intubation and resuscitationPan-scan and damage control surgeryStandardise ICP monitoringDo the intervention.Flog CPP with noradrenaline Use hypothermia, barbiturates to keep ICP