Objectives:

1. Discuss concepts in ICP reduction with blood pressure, autoregulation, and hypertonic therapy.

2. Compare and contrast differences, advantages, and disadvantages of various hypertonic therapy.

3. Review 2 cases of TBI patients with refractory elevations in ICP, requiring pentobarbital coma.

4. Understand the protocol and consequences of pentobarbital on ICP control.

5. Review literature on effectiveness of pentobarbital on ICP control, brain tension oxygen, and outcomes in TBI.