What is Cushing's triad, also known as (Cushing's reflex)?

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From the Guidelines

Cushing triad is a life-threatening combination of hypertension, bradycardia, and irregular respirations that indicates increased intracranial pressure, as noted in the context of acute liver failure 1. The triad consists of three primary physiological signs:

  • Hypertension (elevated blood pressure)
  • Bradycardia (abnormally slow heart rate)
  • Irregular breathing patterns This combination of symptoms occurs as the brain attempts to maintain adequate perfusion in response to rising pressure within the skull. The clinical signs of elevated ICP, including Cushing’s triad, are not uniformly present and are typically evident only late in the course 1. Given the potential for severe morbidity and mortality associated with increased intracranial pressure, prompt recognition and management of Cushing triad are crucial to prevent further brain injury and improve patient outcomes. In clinical practice, the presence of Cushing triad should prompt immediate evaluation and intervention to reduce intracranial pressure, which may include measures such as elevation of the head, hyperventilation, osmotic diuretics like mannitol, or surgical decompression depending on the underlying cause.

From the Research

Definition of Cushing Triad

  • Cushing triad is a set of three primary signs that occur due to increased intracranial pressure (ICP)
  • The three signs are:
    • Increased blood pressure
    • Irregular breathing
    • Reduced heart rate (bradycardia) There are no research papers provided to directly assist in answering this question about Cushing triad, as the studies 2, 3, 4 focus on comparing the effects of hypertonic saline and mannitol in reducing intracranial pressure in patients with traumatic brain injury.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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