Effect of Positive End-Expiratory Pressure on Subdural Intracranial Pressure in Patients Undergoing Supratentorial Craniotomy

  • Birgitte Duch
  • Georg E. Cold


Adult respiratory distress syndrome develops in up to 20% of patients with severe head injury. Positive end-expiratory pressure (PEEP) is often required to support oxygenation. It is well known that PEEP might increase ICP in intensive care patients through decreased cerebral venous outflow as well as an effect on venous return and subsequent reduced mean arterial blood pressure. The effect of PEEP on ICP have been the focus of several experimental and clinical studies, and the results and their interpretation remain controversial. All studies were performed at intensive care units in trauma patients and patients with subarachnoid haemorrhage, but the effect of PEEP, however, have not been investigated during craniotomy. In this chapter 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.


Cerebral Perfusion Pressure Cerebral Aneurysm Adult Respiratory Distress Syndrome Cerebral Tumour Respiratory System Compliance 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2008

Authors and Affiliations

  • Birgitte Duch
    • 1
  • Georg E. Cold
    • 2
  1. 1.Department of NeuroanaesthesiaAarhus University HospitalAarhus CDenmark
  2. 2.Aarhus VDenmark

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