[Elevation of the upper part of the body in acute craniocerebral traumas. Possibilities and limits of intensive therapy].
13 cases of severe cerebral trauma were subjected to varying degrees of elevation of the upper trunk (0 degrees, 15 degrees, 30 degrees, 45 degrees) and to head-raising only (0 degrees, 15 degrees, 30 degrees). The intracranial pressure and mean arterial pressure were measured in these positions. On raising the upper half of the body by 15 degrees, intracranial pressure fell from a mean of 35.3 mm Hg to 28.7 mm Hg, and to 25.2 mm Hg on raising to 30 degrees. Further elevation to 45 degrees resulted in an increase in pressure. In contrast, the mean arterial pressure fell constantly as elevation increased, resulting in a decrease in cerebral perfusion pressure at levels above 30 degrees. In no cases did raising of the head alone result in a lowering of pressure. Instead, potentially dangerous increases were observed.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001930:Brain Injuries / Q000503:physiopathology / Q000628:therapy*; D002560:Cerebrovascular Circulation; D003422:Critical Care; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D011187:Posture
Die Oberkörper-Hochlagerung bei akutem Schädel-Hirn-Trauma. Möglichkeiten und Grenzen in der Intensivtherapie.