PMID: 4758542Dec 15, 1973

Evaluation of hyperventilation in treatment of head injuries

British Medical Journal
H A CrockardW F Morrow

Abstract

Reduction of the partial pressure of carbon dioxide in the arterial blood by mechanical hyperventilation (Pco(2) 25-30 mm Hg; Po(2) 100-150 mm Hg) may be beneficial in cases of severe head injury. To evaluate its efficacy and establish prognostic guidelines intracranial pressure, radiocirculograms, and cerebrospinal fluid (C.S.F.) lactate levels were studied in 31 patients. In survivors intracranial pressure fell and cerebral blood flow improved with treatment. A C.S.F. lactate greater than 55 mg/100 ml was associated with a poor prognosis. Selection of patients was based on clinical judgement, and adults with signs of extensive brain damage were excluded. The importance of an adequate airway and resuscitation is stressed before a final decision is made. The object of treatment is to improve the quality of survival and the criteria measured may aid in the distinction between patients with a potential for good recovery and those capable only of a vegetative existence. Many associated factors as well as hypocapnia reduce intracranial pressure, and these are discussed. We believe that hyperventilation may improve some head injuries, and further study is indicated.

References

Jan 1, 1972·European Neurology·D A BruceM Vapalahti
May 1, 1971·British Journal of Anaesthesia·P M GettG F Shepherd
Jan 1, 1972·Progress in Brain Research·A R TaylorT K Bell
Jan 1, 1972·European Neurology·H A Crockard, A R Taylor
Aug 14, 1971·British Medical Journal·M Vapalahti, H Troupp
May 1, 1968·British Journal of Anaesthesia·C Froman

Citations

Jan 1, 1977·Acta neurochirurgica·H NornesK F Lindegaard
Jul 9, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·P David AdelsonWorld Federation of Pediatric Intensive and Critical Care Societies
Jun 1, 1979·Journal of Neurosurgery·E A Frost
Jun 30, 2014·Journal of the American College of Surgeons·Roy Spence, Robert Spence
Sep 1, 1985·Electroencephalography and Clinical Neurophysiology·E FaccoG P Giron
May 30, 1998·Anesthesiology·J E Brian
Jan 30, 2007·Lancet·Aslam M Khaja, J Grotta
Oct 31, 2006·Surgical Neurology·Ming-dar TsaiShin-Han Tsai
Aug 8, 1981·Lancet·E A CaffreyK G Clark
Apr 5, 2003·Stroke; a Journal of Cerebral Circulation·Harold P AdamsStroke Council of the American Stroke Association
Mar 1, 1974·The British Journal of Surgery·D P ByrnesC A Gleadhill
Oct 1, 1976·The British Journal of Surgery·D L Coppel
Apr 1, 1987·Postgraduate Medicine·S Sterner

Related Concepts

Brain
Carbon Dioxide
Cerebrovascular Circulation
Temporal Region Trauma
Hydrogen-Ion Concentration
Intracranial Pressure
Intubation, Intratracheal
Lactates
Dioxygen
Mechanical Ventilation

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