ABSTRACT
Aims and objectives: The aim of this research was to investigate the effect of five selected intensive care nursing interventions on the
intracranial pressure (ICP) of moderate to severe traumatic brain-injured children in intensive care.
Background: The physiological effects of many nursing interventions in paediatric intensive care (PIC) are not known. This results in the lack
of an evidence base for many PIC nursing practices.
Design: Prospective observational cohort study conducted over 3 years in a single tertiary referral paediatric intensive care unit (PICU) in the
North West of England.
Methods: Five selected commonly performed nursing interventions were studied: endotracheal suctioning and manual ventilation (ETSMV),
turning via a log-rolling (LR) approach, eye care, oral care and washing. These were studied in the first 72 h after injury.
Results: A total of 25 children with moderate to severe traumatic brain injury and intraparenchymal ICP monitoring in intensive care (aged
2–17 years) were enrolled. Both ETSMV and LR were associated with clinically and statistically significant changes in ICP from baseline to
maximal ICP (p = 0·001 ETSMV; p =