Episode 16: Increased ICP Therapy with Dave Mintz

In this episode of the ACCRAC podcast, host Jed Wolpaw interviews Dr. David Mintz, a neuroanesthesiologist, about the therapy for increased intracranial pressure and brain relaxation during neurosurgery. Dr. Mintz discusses various methods to reduce intracranial pressure, including hyperventilation, diuresis (using mannitol and Lasix), steroid administration, patient positioning, CSF drainage, and hypertonic saline. He emphasizes the importance of understanding the underlying physiology, tailoring treatment to the specific clinical scenario (impending herniation vs. brain relaxation), and considering potential side effects and patient-specific factors. The conversation also covers practical considerations like managing urine output with mannitol, potential complications like brain sag, and the importance of communication between the anesthesiologist and the neurosurgeon.