Intracranial pressure responsiveness to positive end-expiratory pressure is influenced by chest wall elastance: a physiological study in patients with aneurysmal subarachnoid hemorrhage

BMC Neurology
Han ChenJian-Xin Zhou

Abstract

Respiratory system elastance (ERS) is an important determinant of the responsiveness of intracranial pressure (ICP) to positive end-expiratory pressure (PEEP). However, lung elastance (EL) and chest wall elastance (ECW) were not differentiated in previous studies. We tested the hypothesis that patients with high ECW or a high ECW/ERS ratio have greater ICP responsiveness to PEEP. An esophageal balloon catheter was placed to measure esophageal pressure. PEEP was increased from 5 to 15 cmH2O. Airway pressure and esophageal pressure were measured and EL, ECW and ERS were calculated at the two PEEP levels. Patients were classified into either an ICP responder group or a non-responder group based on whether the change of ICP after PEEP adjustment was greater than or less than the median of the overall study population. The magnitude of the increase in esophageal pressure (median [interquartile range]) at end-expiratory occlusion was significantly increased in the responder group compared with that in the non-responder group (4.1 [2.7-4.1] versus 2.7 [0.0-2.7] cmH2O, p = 0.033) after PEEP adjustment. ECW and the ECW/ERS ratio were significantly higher in ICP responders than in non-responders at both low PEEP (p = 0.021 and 0.017) and...Continue Reading

References

Feb 1, 1977·Journal of Neurosurgery·J L ApuzzoJ S Heiden
Apr 1, 1978·The Journal of Trauma·H M Shapiro, L F Marshall
Oct 1, 1985·Journal of Neurosurgery·K R CooperS C Choi
Oct 8, 2004·Critical Care : the Official Journal of the Critical Care Forum·Luciano GattinoniFranco Valenza
Jan 26, 2005·Intensive Care Medicine·Luciana MasciaAlessandro Ducati
Dec 24, 2005·Critical Care Medicine·Jeremy M KahnGordon D Rubenfeld
Oct 21, 2006·Intensive Care Medicine·Luciana Mascia
Oct 21, 2006·Intensive Care Medicine·Antonia KoutsoukouCharis Roussos
Dec 1, 2007·Clinical Interventions in Aging·Gulshan Sharma, James Goodwin
Jan 5, 2008·Intensive Care Medicine·Luciana MasciaUNKNOWN Sepsis Occurrence in Acutely Ill Patients (SOAP) Investigators
May 3, 2008·American Journal of Respiratory and Critical Care Medicine·Davide ChiumelloLuciano Gattinoni
Sep 10, 2010·The American Journal of Emergency Medicine·Xiang-Yu ZhangHai-Rong Fan
Mar 8, 2011·Critical Care Medicine·Paolo PelosiUNKNOWN Ventila Study Group
Sep 29, 2011·Critical Care Medicine·Robert E HoeschRobert D Stevens
Nov 2, 2011·Respirology : Official Journal of the Asian Pacific Society of Respirology·Stephen W Littleton
Aug 13, 2014·Intensive Care Medicine·Davide ChiumelloLuciano Gattinoni
Oct 23, 2015·The Journal of Trauma and Acute Care Surgery·Imo P AisikuClaudia S Robertson
Dec 18, 2015·British Journal of Anaesthesia·D ChiumelloL Gattinoni
Feb 9, 2016·World Journal of Critical Care Medicine·Antonia KoutsoukouNikoletta Rovina
Jun 24, 2016·Intensive Care Medicine·Tommaso MauriUNKNOWN PLeUral pressure working Group (PLUG—Acute Respiratory Failure section of the European Society of Intensive Care Medicine)
Sep 17, 2016·Expert Review of Respiratory Medicine·Beatrice BorsellinoFederico Bilotta

❮ Previous
Next ❯

Citations

Mar 12, 2021·Critical Care : the Official Journal of the Critical Care Forum·Varun Suresh, Saurabh Sharma
Mar 4, 2021·Critical Care Medicine·Cherylee W J ChangShreyansh Shah
Jul 7, 2021·Obesity Science & Practice·Sérgio BrasilLuiz Marcelo Sá Malbouisson

❮ Previous
Next ❯

Clinical Trials Mentioned

NCT02670733

Software Mentioned

Lab
ICU
SPSS

Related Concepts

Related Feeds

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.