The Effects Of Using Intracranial Pressure Monitoring In Severe Traumatic Brain Injury:a Meta-analysis

Objective:To evaluate the influences of using intracranial pressure monitoring on hospital mortality, functional outcomes, length of hospital stay and the related complications in patients with severe traumatic brain injury and provide theoretical basis for the clinical use for patients and their families. Methods:The databases of Medlink, Pubmed, Embase, Cochrane Library. Wanfang and CNK.I were searched. The eligible studies were identified for pooled analyses. Results:Six randomized controlled trials with880cases (435patients in ICP monitoring groups and445patients in no-ICP monitoring groups) and12cohort studies with12606cases (4303in ICP monitoring groups and8303patients in no-ICP monitoring groups) were included. Combined analyses showed that ICP monitoring groups was effective for decreasing risk of hospital mortality(RR=0.65,95%C7:0.51-0.82for RCTs, RR=0.91and95%CI:0.78-1.21for cohort studies), rate of electrolyte disturbances (RR=0.51,95%CI:0.33-0.79for RCTs), rale of renal failure (RR=0.46,95%CI:0.28-0.76for RCTs) and for increasing favorable functional outcome (RR=1.31.95%CI:1.12-1.53for RCTs; RR=1.22,95%CI:0.89-1.65for cohort studies). However, ICP monitoring groups was not effective for decreasing rate of pulmonary infection (RR=0.91,95%CI:0.76-1.07for RCTs), rate of using mechanical ventilation (RR=1.28,95%CI:0.75-2.18for cohort studies)and length of hospital stay(WMI5.75.95%CI:-11.40—22.90).Conclusion:For patients with severe traumatic brain injury intracranial pressure monitoring plays an important role in decreasing risk of hospital mortality, rate of electrolyte disturbances, rate of renal failure and increasing favorable functional outcome. But, it was not effective for decreasing rate of pulmonary infection, rate of using mechanical ventilation and length of hospital stay.