[Relevance of ventilatory optimization in acute intracranial hypertension. A clinical, physiological, and therapeutic approach].
Mechanical ventilation in acute traumatic coma is comprehensively approached, by means of comparatively reviewing the pertinent literature. Multivariate clinico-physiologic-therapeutic aspects are presented and discussed, and a proposition is made for ventilatory optimization under circumstances of predominantly diffuse acute brain insults. A novel technique is introduced for practical, bedside quantification of ventilatory adjustments. This technique allows simultaneous optimization of intracranial pressure and global cerebral extraction of oxygen. The latter represents therapeutic coupling between global cerebral blood flow and oxygen metabolism.
Cruz
J
J
Division of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
D000208:Acute Disease; D000328:Adult; D000740:Anemia / Q000150:complications; D001930:Brain Injuries / Q000503:physiopathology; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation; D002648:Child; D003128:Coma / Q000503:physiopathology*; D006801:Humans; D006985:Hyperventilation; D016857:Hypocapnia; D000860:Hypoxia; D008991:Monitoring, Physiologic; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption; D011175:Positive-Pressure Respiration; D011559:Pseudotumor Cerebri / Q000503:physiopathology*; D012121:Respiration, Artificial
D002245:Carbon Dioxide; D010100:Oxygen
Relevância da otimização ventilatória em hipertensão intracraniana aguda. Uma abordagem clínica-fisiológica-terapêutica.