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Effects of Positive End-Expiratory Pressure on Intracranial Pressure and Cerebral Perfusion Pressure

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Intracranial Pressure and Brain Biochemical Monitoring

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 81))

Summary

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. Acute neurological and neurosurgical patients suffer intracranial hypertension and acute lung injury with hypoxemia. Since PEEP may improve hypoxemia but elevate ICP and decrease CPP, it is important to determine the influence of varying levels of PEEP on ICP and CPP. The aim of the study was to investigate the changes in ICP and CPP associated with different levels of PEEP. Twenty patients requiring ICP monitoring and mechanical ventilation were enrolled. Patients had severe head injury (n = 10), spontaneous intracerebral haemorrhage (n = 5), and subarachnoid haemorrhage (n = 5). PEEP was raised from 5 (basal) to 15 cm H2O in steps of 5 cm H2O. After at least 10 minutes of each new PEEP setting, ICP and CPP were measured. PEEP at 10 and 15 cm H2O produced a significant (p<0.05) increase in intracranial pressure 11.6 ± 5.6 and 14.6 ± 6.28 mm Hg, respectively; no significant (p = 0.819) change occurred in CPP.

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Authors and Affiliations

  1. From the ICU, Hospital Nacional“Prof. A. Posadas”, University of Buenos Aires, Haedo, Argentina

    Walter Videtta M.D., F. Villarejo, M. Cohen, G. Domeniconi, R. Santa Cruz, O. Pinillos, F. Rios & B. Maskin

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  1. Walter Videtta M.D.
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  2. F. Villarejo
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  3. M. Cohen
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  4. G. Domeniconi
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  5. R. Santa Cruz
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  6. O. Pinillos
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  7. F. Rios
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  8. B. Maskin
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Editor information

Editors and Affiliations

  1. Addenbrooke’s Hospital, Cambridge, UK

    Marek Czosnyka , John D. Pickard , Peter J. Kirkpatrick , Peter Smielewski  & Peter Hutchinson , , ,  & 

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© 2002 Springer-Verlag

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Videtta, W. et al. (2002). Effects of Positive End-Expiratory Pressure on Intracranial Pressure and Cerebral Perfusion Pressure. In: Czosnyka, M., Pickard, J.D., Kirkpatrick, P.J., Smielewski, P., Hutchinson, P. (eds) Intracranial Pressure and Brain Biochemical Monitoring. Acta Neurochirurgica Supplements, vol 81. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6738-0_25

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  • DOI: https://doi.org/10.1007/978-3-7091-6738-0_25

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7397-8

  • Online ISBN: 978-3-7091-6738-0

  • eBook Packages: Springer Book Archive

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