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Systematic review of decreased intracranial pressure with optimal head elevation in postcraniotomy patients: a meta‐analysis
Author(s) -
Jiang Yan,
Ye Zeng panpan,
You Chao,
Hu Xin,
Liu Yi,
Li Hao,
Lin Sen,
Li JiPin
Publication year - 2015
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12679
Subject(s) - intracranial pressure , medicine , meta analysis , elevation (ballistics) , inclusion and exclusion criteria , surgery , pathology , mathematics , geometry , alternative medicine
Aim To determine an optimal head elevation degree to decrease intracranial pressure in postcraniotomy patients by meta‐analysis. Background A change in head position can lead to a change in intracranial pressure; however, there are conflicting data regarding the optimal degree of elevation that decreases intracranial pressure in postcraniotomy patients. Design Quantitative systematic review with meta‐analysis following Cochrane methods. Data sources The data were collected during 2014; three databases (PubMed, Embase and China National Knowledge Internet) were searched for published and unpublished studies in English. The bibliographies of the articles were also reviewed. The inclusion criteria referred to different elevation degrees and effects on intracranial pressure in postcraniotomy patients. Review methods According to pre‐determined inclusion criteria and exclusion criteria, two reviewers extracted the eligible studies using a standard data form. Results These included a total of 237 participants who were included in the meta‐analysis. (1) Compared with 0 degree: 10, 15, 30 and 45 degrees of head elevation resulted in lower intracranial pressure. (2) Intracranial pressure at 30 degrees was not significantly different in comparison to 45 degrees and was lower than that at 10 and 15 degrees. Conclusion Patients with increased intracranial pressure significantly benefitted from a head elevation of 10, 15, 30 and 45 degrees compared with 0 degrees. A head elevation of 30 or 45 degrees is optimal for decreasing intracranial pressure. Research about the relationship of position changes and the outcomes of patient primary diseases is absent.