[The course of intracranial pressure during respirator weaning after severe craniocerebral trauma].
To analyze the characteristics of hemodynamic parameters and cerebral dynamics, the courses of intracranial pressure (ICP), cerebral perfusion pressure (CPP), mean arterial blood pressure (MAP) and PaCO2 were analyzed retrospectively in 29 patients with severe head injury, comparing periods before and after the ventilatory mode was changed from controlled mechanical ventilation to spontaneous breathing with continuous positive airway pressure. Measurements were done before and after changing of the ventilation. Patients were allocated either to group I (n = 22, ICP remained stable: 18 +/- 2 mm Hg in both periods of observation) or group II (n = 7, ICP increased from 25 +/- 3 mm Hg to 33 +/- 4 mm Hg, P < 0.05). While changes of MAP did not reach significant levels in either group, concomitant changes in CCP appeared in group II (67 +/- 2 mm Hg to 60 +/- 2 mm Hg). Based on the observation of relatively high incidence of ICP increases and deterioration of CPP during weaning from ventilator, it is recommended that continuous ICP monitoring should be continued.
Jaskulka
R
R
Universitäts-Klinik für Unfallchirurgie Wien.
Weinstabl
C
C
Schedl
R
R
D000293:Adolescent; D000328:Adult; D001929:Brain Edema / Q000503:physiopathology*; D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation / Q000502:physiology; D002648:Child; D005260:Female; D016489:Head Injuries, Closed / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D015300:Ventilator Weaning
D002245:Carbon Dioxide
Verlauf des intrakraniellen Drucks während der Entwöhnung vom Respirator nach schwerem Schdel-Hirn-Trauma.