Neuroanesthesia & neurocritical care
Short-term mild hyperventilation on intracranial pressure, cerebral autoregulation, and oxygenation in acute brain injury patients: a prospective observational study
Authors' conclusion
Mild hyperventilation can reduce ICP and improve cerebral autoregulation, with minimal clinical effects on cerebral oxygenation. However, the arterial component of rSO2 was importantly reduced.
Study context
- Population
- Patients with acute brain injury in the ICU undergoing multimodal neuromonitoring and requiring PaCO2 titration to mild hypocapnia as tier 2 management of intracranial hypertension40% female
- Participants
- 25 patients
- Exposure
- Before vs after induction of mild hyperventilation
- Outcome
- Changes in ICP, cerebral autoregulation (PRx) and regional cerebral oxygenation (rSO2)
Methodological detailssingle-centre, before-after
- Single-centre
- Before-after
Main finding
As reported in the abstract
ICP, PRx, rSO2
- Intracranial pressure (ICP), median (IQR), before → after: 25.4 (24.1-26.4) → 17.5 (16-21.2) mmHg; p < 0.0001
- PRx, median (IQR), before → after: 0.32 (0.1-0.52) → 0.12 (−0.03-0.23); p < 0.0001
- rSO2, median (IQR), before → after: 60% (56-64) → 59% (54-61); p < 0.0001 (statistically but not clinically significant)
- ΔO2Hbi (arterial component of rSO2), before → after: 3.83 (3-6.2) → 1.6 (0.5-3.1) μM.cm; p = 0.0001
Observational data: associations, not effects.
Further findings
- PaCO2, before → after: 42 (39-44) → 34 (32-34) mmHg; p < 0.0001
Original publication
Short-term mild hyperventilation on intracranial pressure, cerebral autoregulation, and oxygenation in acute brain injury patients: a prospective observational study. J Clin Monit Comput. Published 4 February 2024. doi:10.
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