• F Murillo-Cabezas and D A Godoy.
• Servicio de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: ancisco.murillo.sspa@juntadeandalucia.es.
• Med Intensiva. 2014 May 1;38(4):237-9.

AbstractThe present study outlines a series of questions and reflections upon the recent publication of Chesnut et al., who compared 2 approaches to the treatment of intracranial hypertension (ICH) in severe head injuries: one with and the other without intracranial pressure monitoring (ICP). The authors concluded that no improved outcome was observed in the treatment group guided by ICP monitoring. The main concerns relate to the degree of training of the physicians involved in the monitoring and management of ICH in the ICP group, as well as to the possible inter-observer variability in interpreting the CT scans, the capacity of clinical signs to guide the treatment of ICH, and the suitability of randomization. The analysis of this trial should not be taken to suggest the futility of ICP monitoring but rather the need to correctly use the information afforded by ICP monitoring, with emphasis on the importance of the definition of alternative methods for non-invasive monitoring.Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

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