Neuroanesthesia & neurocritical care
Effects of positive end-expiratory pressure on brain oxygenation, systemic oxygen cascade and metabolism in acute brain injured patients: a pilot physiological cross-sectional study
Authors' conclusion
PEEP augmentation test did not affect cerebral and systemic oxygenation or metabolism. Changes in cerebral oxygenation significantly correlated with DO2, SaO2, and VCO2.
Study context
- Population
- Adults (> 18 y/o) with acute brain injury, stable ICP, gas exchange and indirect calorimetry monitoring, academic hospital
- Participants
- 10 adults
- Exposure
- Positive end-expiratory pressure (PEEP) 15 vs 5 cmH2O
- Outcome
- Effects of PEEP augmentation (5 to 15 cmH2O) on brain oxygenation (near-infrared spectroscopy (NIRS)), systemic oxygen cascade and metabolism
Methodological detailspilot, physiological, observational, single-centre
- Pilot
- Physiological
- Observational
- Single-centre
Main finding
As reported in the abstract
Cerebral oxygenation, systemic oxygen cascade and metabolism
- PEEP augmentation from 5 to 15 cmH2O did not affect cerebral oxygenation, systemic oxygen cascade parameters, or metabolism
Observational data: associations, not effects.
Further findings
Correlation of cerebral oxygenation with DO2, saturation of oxygen (SaO2) and VCO2
- ΔO2Hbi vs DO2, rho
- 0.717
- ΔO2Hbi vs DO2, p
- P = 0.037
- ΔrSO2 vs SaO2, rho
- 0.727
- ΔrSO2 vs SaO2, p
- P = 0.032
- ΔcHbi vs SaO2, rho
- 0.797
- ΔcHbi vs SaO2, p
- P = 0.013
- ΔHHBi vs SaO2, rho
- 0.816
- ΔHHBi vs SaO2, p
- P = 0.009
- ΔrSO2 vs VCO2, rho
- 0.681
- ΔrSO2 vs VCO2, p
- P = 0.049
- ΔO2Hbi not correlated with SaO2
Correlation of brain oxygenation with ventilatory parameters
- No correlation found
Original publication
Effects of positive end-expiratory pressure on brain oxygenation, systemic oxygen cascade and metabolism in acute brain injured patients: a pilot physiological cross-sectional study. J Clin Monit Comput. Published 15 July 2023. doi:10.
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