Document Detail

Controlled hyperventilation in patients with intracranial hypertension. Application and management.
MedLine Citation:
PMID:  6404229     Owner:  NLM     Status:  MEDLINE    
When elevated intracranial pressure (ICP) complicates the course of various forms of cerebral edema, the likelihood of survival with full recovery is greatly diminished. Controlled mechanical hyperventilation effectively lowers ICP in some patients by causing cerebral vasoconstriction. Improved survival occurs in patients with elevated ICP from head trauma and intracranial infection treated with hyperventilation; however, no benefit has been demonstrated in patients with increased ICP from strokes or hypoxic brain damage. Proper management of the hyperventilation requires knowledge of basic cerebral circulatory physiology. Arterial Paco2 tensions should be maintained between 25 and 30 mm Hg. Vasoconstrictive effects of hyperventilation diminish after 48 to 72 hours when renal mechanisms compensate for the respiratory alkalosis. When hyperventilation is discontinued, the Paco2 must be gradually returned to normal values, since sudden changes may cause a marked rise in ICP.
J E Heffner; S A Sahn
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of internal medicine     Volume:  143     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1983 Apr 
Date Detail:
Created Date:  1983-05-05     Completed Date:  1983-05-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  765-9     Citation Subset:  AIM; IM    
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MeSH Terms
Brain / blood supply
Brain Edema / mortality,  therapy*
Carbon Dioxide / deficiency
Cerebrovascular Disorders / therapy
Craniocerebral Trauma / therapy
Encephalitis / therapy
Hypoxia, Brain / therapy
Intracranial Pressure*
Meningitis / therapy
Respiration, Artificial / methods*
Time Factors
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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