TIL 0 |
TIL 0 |
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No specific ICP directed therapy |
TIL 1 - Core ICU care |
TIL 1 - Core ICU care |
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Sedation for ventilator/endotracheal tube tolerance, Volume/Vasoactives for non-CNS cause (e.g. sepsis, myocardial injury), Head-up positioning (ventilator bundle), Normcapnia (PaCO2 greater than or equal to 40 mmHg) |
TIL 2 - Mild |
TIL 2 - Mild |
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Higher levels of sedation, Vasopressors/volume for CPP support, Low dose osmotic therapy, Mild hypocapnia (PaCO2: 4.6 - 5.3 kPa| 35 – 40 mmHg), CSF drainage <120 ml/day (<5 ml/hr) |
TIL 3 - Moderate |
TIL 3 - Moderate |
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Higher doses of osmotic therapy, Moderate hypocapnia (PaCO2: 4.0 - 4.5 kPa| 30 – 35 mmHg), Mild hypothermia (>35°C), CSF drainage greater than or equal to 120 ml/day (greater than or equal to 5 ml/hr) |
TIL 4 - Extreme |
TIL 4 - Extreme |
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Profound hypocapnia (PaCO2: <30 mmHg), Temperature <35°C, Metabolic suppression with IV anesthetics, Surgery for refractory ICP (decompression/lobectomy) |