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

脑灌注压 颅内压 医学 呼气末正压 麻醉 机械通风 第七节 颅内压监测 创伤性脑损伤 重症监护 蛛网膜下腔出血 脑积水 脑血流 外科 重症监护医学 精神科
作者
Glenn McGuire,David Crossley,Jonathan Richards,David T. Wong
出处
期刊:Critical Care Medicine [Ovid Technologies (Wolters Kluwer)]
卷期号:25 (6): 1059-1062 被引量:186
标识
DOI:10.1097/00003246-199706000-00025
摘要

To determine the influence of positive end-expiratory pressure (PEEP) on intracranial pressure and cerebral perfusion pressure.Neurosurgical intensive care patients requiring intracranial pressure monitoring and mechanical ventilation were studied in a randomized, controlled study.Tertiary care, neurosurgical intensive care unit.Eighteen patients were enrolled in the study. Patients had posttraumatic head injuries (n = 9), subarachnoid hemorrhage (n = 7), obstructive hydrocephalus (n = 1), and intracerebral hemorrhage of unknown cause (n = 1).Patients had PEEP levels of 5, 10, and 15 cm H2O applied to their lungs.Changes in intracranial pressure, mean arterial pressure, and cerebral perfusion pressure were measured. The results were analyzed separately for patients with normal and increased intracranial pressure (> 15 mm Hg). PEEP at 5 cm H2O had no effect on intracranial pressure in the group with normal intracranial pressure. However, PEEP at 10 and 15 cm H2O produced a significant (p < .05) increase in intracranial pressure (1.9 and 1.5 mm Hg, respectively). In the group with increased intracranial pressure, no significant change in intracranial pressure occurred at any of the PEEP levels used. In both groups, cerebral perfusion pressure was unchanged throughout.In patients with normal intracranial pressure, PEEP at 5 cm H2O did not significantly alter intracranial pressure. The clinical relevance of the intracranial pressure increase at PEEP levels of 10 and 15 cm H2O is questionable because cerebral perfusion pressure did not change and remained > 60 mm Hg. In patients with increased intracranial pressure, higher levels of PEEP did not significantly change intracranial pressure or cerebral perfusion pressure.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
佛山湛江发布了新的文献求助10
刚刚
Revision完成签到,获得积分10
1秒前
浅尝离白应助weiweiwu12采纳,获得10
1秒前
2秒前
3秒前
嘻嘻完成签到 ,获得积分10
3秒前
4秒前
111完成签到,获得积分10
4秒前
4秒前
cjw11发布了新的文献求助10
5秒前
6秒前
怡然雨雪发布了新的文献求助10
7秒前
安好完成签到,获得积分10
8秒前
8秒前
科研通AI2S应助123456采纳,获得10
9秒前
able发布了新的文献求助10
9秒前
purejun发布了新的文献求助10
10秒前
天选之子发布了新的文献求助10
10秒前
10秒前
安好发布了新的文献求助10
10秒前
12秒前
开心发布了新的文献求助10
13秒前
14秒前
King发布了新的文献求助10
14秒前
L666发布了新的文献求助20
15秒前
16秒前
16秒前
purejun完成签到,获得积分20
17秒前
18秒前
123456发布了新的文献求助10
21秒前
22秒前
张纠纠发布了新的文献求助10
23秒前
打打应助cui采纳,获得10
23秒前
脑洞疼应助愉快的千柳采纳,获得10
24秒前
天选之子完成签到,获得积分10
24秒前
25秒前
25秒前
小马甲应助看小龙虾打架采纳,获得10
27秒前
顺利的耶发布了新的文献求助10
27秒前
搜集达人应助经管研究生采纳,获得30
28秒前
高分求助中
Kinetics of the Esterification Between 2-[(4-hydroxybutoxy)carbonyl] Benzoic Acid with 1,4-Butanediol: Tetrabutyl Orthotitanate as Catalyst 1000
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Very-high-order BVD Schemes Using β-variable THINC Method 568
Chen Hansheng: China’s Last Romantic Revolutionary 500
XAFS for Everyone 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3138196
求助须知:如何正确求助?哪些是违规求助? 2789101
关于积分的说明 7790287
捐赠科研通 2445509
什么是DOI,文献DOI怎么找? 1300476
科研通“疑难数据库(出版商)”最低求助积分说明 625925
版权声明 601046