2021年9月28日 · In summary, the positive effect of “low-normal PaCO2” management during the first 2 weeks after aneurysm rupture on the risk of DCI, intractable ICP increase and poor outcome after aSAH might ...

2024年1月31日 · The use of arterial partial pressure of carbon dioxide (PaCO 2) as a target intervention to manage elevated intracranial pressure (ICP) and its effect on clinical outcomes remain unclear.

2021年2月1日 · The combined targeting reduced the episodes of brain hypoxia by 66% (p < 0.0000147) with a trend towards lower mortality and better neurologic outcomes (GOS-E at 6 months). In this study when ICP was >20 mmHg with a PbtO2 > 20 mmHg (scenario B), the use of HV to obtain a PaCO 2 of 32–35 mmHg was allowed [41].

Purpose: To describe the management of arterial partial pressure of carbon dioxide (PaCO 2) in severe traumatic brain-injured (TBI) patients, and the optimal target of PaCO 2 in patients with high intracranial pressure (ICP). Methods: Secondary analysis of CENTER-TBI, a multicentre, prospective, observational, cohort study.

Hypercapnia causes the oxyhemoglobin dissociation curve to shift to the right, reducing systemic vascular resistance and increasing tissue oxygen availability. 14 Increased ICP not only leads to a decrease of CBF in the ischemic region, but also causes an increased risk of cerebral hemorrhage in stroke.

2021年7月24日 · The primary aim was to describe current practice in PaCO 2 management during the first week of intensive care unit (ICU) after TBI, focusing on the lowest PaCO 2 values. We also assessed PaCO 2 management in patients with and without ICP monitoring (ICP m), and with and without intracranial hypertension.

Induced hyperventilation with hypocapnia has been used for the acute treatment of intracranial hypertension and critically raised ICP. In patients with high ICP, reductions in CBF and the resultant decrease in intracranial blood volume can provide a lifesaving, albeit temporary, decrease in ICP and restoration of cerebral perfusion pressure.

It is well known that the partial pressure of arterial CO2 (PaCO2) can affect cerebral blood flow, cerebral blood volume, and therefore ICP. The end-tidal CO2 (ETCO2) is usually monitored by clinicians as a proxy for PaCO2. We show examples where subclinical fluctuations in ETCO2 are associated with clinically significant fluctuations in ICR.

This study describes a new method for evaluating vascular reactivity in head-injured patients by determining the sensitivity of ICP change to alterations in PCO2. This method was combined with measurements of the pressure volume index (PVI), which allowed calculation of blood volume change necessary to alter ICP.

It is generally acknowledged that the decreasing of PaCO2 leads to lower ICP values 22 and the pathophysiological background of this effect is related to arteriolar vasoconstriction, especially in the pial and cortical vessels.