Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients.

@article{Frost1977EffectsOP,
  title={Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients.},
  author={Elizabeth A. M. Frost},
  journal={Journal of neurosurgery},
  year={1977},
  volume={47 2},
  pages={
          195-200
        }
}
  • E. Frost
  • Published 1 August 1977
  • Medicine
  • Journal of neurosurgery
Hypoxic pulmonary disorders and head injuries associated with increased intracranial pressure (ICP) frequently co-exist. Positive end-expiratory pressure (PEEP) improves hypoxemia but has been reported to impede cerebral venous return, potentially causing a further increase in ICP. This study examined the effects of PEEP on ICP at different levels of brain compliance. continuous ICP recordings were obtained after insertion of Scott cannulas to the lateral ventricles of seven comatose patients… 
View on PubMed
thejns.org
94 Citations
Highly Influential Citations
5
Background Citations
15
Methods Citations
2
Results Citations
2

94 Citations

Citation Type

Citation Type

The Effect of Positive End-Expiratory Pressure on Intracranial Pressure and Cerebral Hemodynamics
TLDR
The results suggest that PEEP can be applied safely in patients with acute brain injury as it does not have a clinically significant effect on ICP or CPP.
Effects of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure.
TLDR
The effect of positive end-expiratory pressure (PEEP) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) has been reported by several investigators, without any consensus being reached, and it is important to determine the influence of varying levels of PEEP on ICP and CPP.
Influence of Positive End-Expiratory Pressure on Intracranial Pressure and Cerebral Perfusion Pressure in Patients With Acute Stroke
TLDR
PEEP increase up to 12 mm Hg does not significantly influence ICP, and the observed marked changes in CPP are mediated through the MAP, suggesting that PEEP application should be safe, provided that MAP is maintained.
Cerebro-pulmonary interactions during the application of low levels of positive end-expiratory pressure
Objective In patients with severe brain injury and acute lung injury the use of positive end-expiratory pressure (PEEP) is limited by conflicting results on its effect on intracranial pressure. We…
Effect of increased positive end-expiratory pressure on intracranial pressure and cerebral oxygenation: impact of respiratory mechanics and hypovolemia
TLDR
The impacts of PEEP on ICP and cerebral oxygenation are determined by both volume status and respiratory mechanics and potential conditions that may increase chest wall elastance should be ruled out to avoid the deleterious effects of PEP.
Effect of Positive End-Expiratory Pressure on Subdural Intracranial Pressure in Patients Undergoing Supratentorial Craniotomy
TLDR
The effects of 5 and 10 cmH2O PEEP on subdural ICP, cerebral perfusion pressure and jugular bulb pressure were studied during craniotomy for cerebral tumours or cerebral aneurysms.
Effects of Positive End Expiratory Pressure (PEEP) on Intracranial and Cerebral Perfusion Pressure In Pediatric Neurosurgical Patients
TLDR
PEEP values up to 8 cm H2O seem to be safe in pediatric patients with intracranial neoplasm, and, in the authors' opinion, PEEP should be applied immediately after surgery to restore lung recruitment.
Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure.
TLDR
In patients with normal intracranial pressure, PEEP at 5 cm H2O did not significantly alter intrac Cranial pressure and cerebral perfusion pressure, and in patients with increased intrusion pressure, higher levels of PEEP did not significant change intrac cranial pressure or cerebral perfusions pressure.
Intracranial pressure responsiveness to positive end-expiratory pressure in different respiratory mechanics: a preliminary experimental study in pigs
TLDR
Different respiratory mechanics models can be established via hydrochloride induced lung injury and chest wall and abdominal strapping: chest wall elastance (ECW), lung elastances (EL), and baseline ICP.
Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: the role of respiratory system compliance.
TLDR
In patients with low Crs, PEEP has no significant effect on cerebral and systemic hemodynamics, and monitoring of Crs may be useful for avoiding deleterious effects of PEEP on the intracranial system of patients with normal Crs.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 13 REFERENCES
The Response of Brain Surface Pressure to Hypercapnic Hypoxia and Hyperventilation
TLDR
The findings suggest that swelling of the brain occurs during hypercapnic hypoxia and is not reversed by an hour of hyperventilation, and the lack of correlation between cisternal CSF and brain surface pressures suggests that CSF was displaced from the cranium while brain volume expanded.
Continuous Positive-Pressure Ventilation in Acute Respiratory Failure
TLDR
Prevention of air-space collapse during expiration and an increase in functional residual capacity probably explain improved oxygenation with continuous positive-pressur...
Effect of central venous pressure on brain tissue pressure and brain volume.
TLDR
It was concluded that congestive edema does not occur in the brain unless the tissue is damaged, however, venous hypertension does cause brain swelling.
Hemodynamic alterations with positive end-expiratory pressure: the contribution of the pulmonary vasculature.
TLDR
The hemodynamic responses to positive end-expiratory pressure (PEEP) ventilation have been evaluated and suggest that there is a high resistance to flow in the pulmonary circulation and that a lower level of PEEP should be used.
Cerebrospinal fluid pressures during halothane anaesthesia
TLDR
Elevations of cerebrospinal fluid pressure corresponded with increases in the venous pressure, while arterial pressure decreased concomitantly during the period of undisturbed halothane anaesthesia, and the magnitude of these changes was proportional to the concentration of Halothane.
Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system.
The distribution of compliance and outflow resistance between cerebral and spinal compartments was measured in anesthetized, ventilated cats by analysis of the cerebrospinal fluid (CSF) pressure…
Use of balloon flotation catheters in critically ill patients.
Compartmental analysis of compliance and J. Neurosurg
  • J Neurosurg 43:523-534,
  • 1977
Effects of positive end-expiratory pressure (PEEP) on intracranial pressure, sagittal sinus ar ~1 cerebral perfusion pressures during experimental intracranial hypertension in cat
  • Proceedings of the American Association of Neurological Surgeons, 43rd Annual Meeting,
  • 1975
Improvement of oxygenation in the adult respiratory distress syndrome by PEEP
  • Respir Care 16:173-176,
  • 1971
...
1
2
...