Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure

McGuire, Glenn; Crossley, David; Richards, J. R.; Wong, David T.

doi:10.1097/00003246-199706000-00025

Cited by 184 publications

(91 citation statements)

References 14 publications

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“…The technique depends on absorption of near infrared light by the chromophores HbO 2 and deoxygenated Hb. Changes in concentration can be calculated from changes in absorption [23]. A correlation of NIRS data with blood flow measured by microsphere quantitations has been shown for piglets [24].…”

Section: Measurementsmentioning

confidence: 93%

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Burkhardt

Proquitté²,

Krause³

et al. 2002

Neonatology

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Intrapulmonary administration of perfluorochemicals (PFC) has been suggested for reasons other than respiratory insufficiency. PFC application has been described to affect cerebral Hb concentration, however, data for healthy lungs are missing. Newborn piglets were randomized into 3 groups (30-ml slow-filling, 10-ml slow-filling and 30-ml rapid-filling), orally intubated and mechanically ventilated. Partial liquid ventilation (PLV) was initiated by filling the lung with PF5080 (10 or 30 ml/kg) at a rate of 1.5 ml/min (slow filling) or within 45 s (rapid filling). Vital signs, blood gases, tidal volume (VT) and changes in the cerebral concentration of oxygenated hemoglobin (HbO₂) and total Hb were determined for up to 20 min. Rapid administration of PFC caused an immediate drop in HbO₂, PaO₂ and VT. The concentration of oxygenated and total Hb increased thereafter and remained high. We found a slow increase in PaCO₂, HbO₂ and total Hb in the 30-ml slow-filling group, but almost no changes in the 10-ml slow filling group (except for a decrease in PaO₂). According to our data, PLV with 10 ml/kg should be preferred since cerebral alterations are minimal. If complete filling of the lung is needed PFC should be administered slowly to minimize side effects.

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Section: Measurementsmentioning

confidence: 93%

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Burkhardt

Proquitté²,

Krause³

et al. 2002

Neonatology

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“…The use of PEEP in patients with increased ICP may cause harmful ICP increases, (13) although finding this is controversial. (16) Intra-abdominal pressure can apparently affect intracranial pressure, likely because of increased venous and intra-thoracic pressures. (7,8) Peritoneostomy has been described as a rescue therapy for refractory intracranial hypertension patients.…”

Section: Discussionmentioning

confidence: 99%

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

Zampieri¹,

Almeida²,

Schettino³

et al. 2011

Rev. bras. ter. intensiva

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“…Luce et al [81] documented in an animal study that the consequences of PEEP on ICP were more evident whenever the applied PEEP was higher than ICP. Later, McGuire et al [82] , in a clinical study, provided evidence that PEEP levels up to 15 mH2O were not transmitted to central nervous system if baseline ICP values were higher than the applied PEEP.…”

Section: Respiratory Mechanics and Gas Exchangementioning

confidence: 99%

Respiratory mechanics in brain injury: A review

Koutsoukou

Katsiari

Orfanos

et al. 2016

WJCCM

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Several clinical and experimental studies have shown that lung injury occurs shortly after brain damage. The responsible mechanisms involve neurogenic pulmonary edema, inflammation, the harmful action of neurotransmitters, or autonomic system dysfunction. Mechanical ventilation, an essential component of life support in brain-damaged patients (BD), may be an additional traumatic factor to the already injured or susceptible to injury lungs of these patients thus worsening lung injury, in case that non lung protective ventilator settings are applied. Measurement of respiratory mechanics in BD patients, as well as assessment of their evolution during mechanical ventilation, may lead to preclinical lung injury detection early enough, allowing thus the selection of the appropriate ventilator settings to avoid ventilatorinduced lung injury. The aim of this review is to explore the mechanical properties of the respiratory system in BD patients along with the underlying mechanisms, and to translate the evidence of animal and clinical studies into therapeutic implications regarding the mechanical ventilation of these critically ill patients.

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Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure

Cited by 184 publications

References 14 publications

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Cerebral Oxygenation Is Affected by Filling Mode and Perfluorochemical Volume in Partial Liquid Ventilation of Healthy Piglets

Modulação da pressão intracraniana em um modelo experimental de hipertensão abdominal e lesão pulmonar aguda

Respiratory mechanics in brain injury: A review

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