The patient is emergently taken to the OR. Due to the severity of injury, the left-sided bone flap is left off, and a right frontal intraparenchymal monitor is placed. He is brought to the NCCU post-operatively and remains intubated.
On day 2 of admission, you return to the ICU and find that he's now developed elevated ICPs, now up to 26mmHg sustained for 15 minutes. His head of bed is already at 45 degrees. He's been maintained on propofol gtt at 60mcg/kg/min, and his RASS score is currently -1. You look up at the monitor, and his EtCO2 is currently 32. The ventilator is set at VC/AC, with Vt 6mL/kg, PEEP 5, RR 20.
Copyright © 2024-2025 Andrew M. Nguyen, M.D. For educational use only.
This work is licensed under
CC BY-NC-SA 4.0.
