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What is All of the following lower intracranial pressure except- and explain in detail?
Following steps are used to lower intracranial pressure Ventrititlostomy to drain CSF Elevate head end of bed Osmotherapy -- mannitol, hypeonic saline Glucocoiciods dexamethasone for vasogenic edema from tumor, abscess (avoid glucocoicoids in head trauma, ischemic and hemorrhagic stroke) Sedation (morphine, propofol, or midazolam) add neuromuscular paralysis if necessary Hyperventilation -to PaCO2 30-35 mmHg Pressor therapy--phenylephtine, dopamine, or norepinephrine to maintain adequate MAP to ensure CPP >/= 60 mmHg, Second-tier therapies for refractory elevated ICP High dose barbiturate therapy (pentobarb coma) Aggressive hyperventilation to Pam< 30 mmHg Hypothermia Hemicraniectomy Ref : Harrison 17/e p1722