The effects of rigid collar placement on intracranial and cerebral perfusion pressures

Citation
K. Hunt et al., The effects of rigid collar placement on intracranial and cerebral perfusion pressures, ANAESTHESIA, 56(6), 2001, pp. 511-513
Citations number
12
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Journal title
ANAESTHESIA
ISSN journal
00032409 → ACNP
Volume
56
Issue
6
Year of publication
2001
Pages
511 - 513
Database
ISI
SICI code
0003-2409(200106)56:6<511:TEORCP>2.0.ZU;2-B
Abstract
Rigid collars are routinely used to immobilise the cervical spine during ea rly management of trauma victims until spinal injury is excluded. Spinal in juries commonly coexist in patients with severe head injury, and there is s till uncertainty as to whether application of a rigid collar may adversely affect intracranial pressure. The aim of this study was to examine this eff ect by applying rigid collars to patients with traumatic head injury. The r esults showed a significant rise from the baseline intracranial pressure wh en the collars were applied (mean rise = 4.6 mmHg, p < 0.0001). The mean ri se in intracranial pressure was greater in those patients with a baseline i ntracranial pressure > 15 mmHg compared to those with a baseline intracrani al pressure < 15 mmHg (p < 0.05). Since there was no significant change in cardiorespiratory parameters during this time, venous compression in the ne ck seems a likely explanation for the effect observed. These findings sugge st that in head-injured patients, rigid collars should be removed as soon a s cervical spine injury has been excluded or, if this is delayed, an altern ative method of spinal stabilisation considered.