Effect of pedal pump and thoracic pump techniques on intracranial pressure in patients with traumatic brain injuries.

Context: Although osteopathic manipulative treatment (OMT) is used to manage myriad conditions, there has been some hesitation regarding the safety of applying OMT to patients with intracranial injuries or elevated intracranial pressure (ICP).

Objective: To assess the safety of two OMT techniques--pedal pump and thoracic pump--on ICP and cerebral perfusion pressure (CPP) in patients with traumatic brain injuries (Glasgow Coma Scale score < or =8).

Methods: We prospectively enrolled consecutive patients admitted to the intensive care unit (ICU) for traumatic brain injury.