Document Detail

Effects of pressure- and volume-controlled inverse ratio ventilation on haemodynamic variables, intracranial pressure and cerebral perfusion pressure in rabbits: a model of subarachnoid haemorrhage under isoflurane anaesthesia.
MedLine Citation:
PMID:  12974589     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: An inverse I : E ratio (inspiratory time > expiratory time) may have benefits in patients suffering trauma who requiring lung ventilation. However, this application may be deleterious if there is concomitant head injury. We aimed to determine the physiological effects of pressure- and volume-controlled modes of inverse ratio (I : E = 2 : 1) ventilation of the lungs, while maintaining normocapnia, in a rabbit model of raised intracranial pressure (ICP). METHODS: New Zealand White rabbits were anaesthetized with isoflurane and a tracheostomy was performed. Subarachnoid haemorrhage was simulated in two groups by injecting blood into the cisterna magna. Groups 1 and 2 (n = 6, each), controls, were compared with Groups 3 and 4 (n = 6, each) with the simulated subarachnoid haemorrhage. Each ventilation mode was used with an I : E ratio of 2 : 1 for 30 min. Mean arterial pressure (MAP), ICP, cerebral perfusion pressure (CPP), mean airway pressure (P(AW)) and arterial blood-gas status were measured. RESULTS: Both modes increased mean P(AW) (P < 0.02). This increase was greater with the volume-controlled mode (P < 0.02). The baseline value averaged 5.8 +/- 0.4 and 5.6 +/- 0.3 mmHg in Groups 3 and 4, respectively, and increased to 7.8 +/- 0.3 and 10.8 +/- 0.4 mmHg. Inducing subarachnoid haemorrhage increased ICP and MAP (P < 0.02). Baseline ICPs were 10.3 +/- 0.5 and 10.3 +/- 0.4 mmHg in Groups 1 and 2, respectively, whereas they were 25.4 +/- 1.2 and 25.8 +/- 0.8 mmHg in Groups 3 and 4. However, ICP, MAP and CPP did not differ significantly according to the mode. CONCLUSIONS: An already raised ICP was altered by the application of induced mean PAW increases as a consequence of inverse ratio ventilation of the lungs with normocapnia.
A Taplu; N Gökmen; S Erbayraktar; B Sade; N Erkan; K Karadibak; A Arkan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  20     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-16     Completed Date:  2004-02-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  690-6     Citation Subset:  IM    
Dokuz Eylül University School of Medicine, Department of Anaesthesiology, Izmir, Turkey.
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MeSH Terms
Anesthetics, Inhalation / administration & dosage
Disease Models, Animal
Hemodynamics / physiology*
Intracranial Pressure / physiology*
Isoflurane / administration & dosage*
Monitoring, Physiologic
Respiration, Artificial / methods*
Subarachnoid Hemorrhage / physiopathology*
Reg. No./Substance:
0/Anesthetics, Inhalation; 26675-46-7/Isoflurane

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