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ISSN 2448-8909 (Print)

1999, Number 2

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Med Crit 1999; 13 (2)

Hyperventilation in severe head trauma and brain tissue oxygen pressure monitoring

Carmona SJA, Maas A

Language: Spanish
References: 43
Page: 49-58
PDF size: 172.32 Kb.


ABSTRACT

Objective. To describe hyperventilation effects on brain tissue oxygenation (ptbO2).
Design. Prospective and observational study.
Setting. Neurologic Intensive Care Unit.
Patients. Ninety severe head trauma (GCS ≤ 8) patients.
Interventions. Continuous monitoring of ICP, CPP, and ptbO2, measured by Clark cerebral intraparenchimal catheter and arterial blood gases samples before and after hyperventilation.
Measurements and principle results. Daily, during initial five days after trauma, minute volume of the ventilator setting was increased 20% over baseline value during 15 minutes. Baseline PaCO2 creased 3.3 ± 1.8 mm Hg (p ‹ 0.001), from 32.3 ± 4.5 mm Hg ptbO2 decreased an average of 2.8 ± 3.7 mm Hg (p ‹ 0.001). An increased trend in time of D ptbO2 was observed, from 8 ± 2.3 mm Hg on day 1 reached to 6.1 ± 2.3 mm Hg on day 5. With PaCO2 calculation, on initial two days after trauma not significantly difference was observed between outcome groups (good and poor outcome). However, from day 3 to 5 an higher trend oxygen reduction was demonstratred in-patients with poor outcome, in compare with good outcome groups, being statistically on day 5 (p ‹ 0.05).
Conclusion. Hyperventilation decreased ptbO2, which is a high risk factor for brain ischemia. The increased reactivity of PaCO2 between day 2 to 5 affects cerebral oxygenation.


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