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Article10.1161/circ.124.suppl_21.a8

Abstract 8: Elevated Intrathoracic Pressure Is Common During Prehospital Ventilation of Patients with Traumatic Brain Injury

Daniel Davis,Kimberly A. Smith,Morgan C Ludington,Anush Minokadeh,James V. Dunford-2011-11-22-Circulation
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Background: Inadvertent hyperventilation is associated with poor outcomes from traumatic brain injury (TBI). Hypocapneic cerebral vasoconstriction is well described and causes an immediate and profound decrease in cerebral perfusion. The hemodynamic effects of positive-pressure ventilation (PPV) remain incompletely understood but may be equally important, particularly in the hypovolemic patient with TBI. Objective: To apply a previously described mathematical model of perfusion and ventilation to prehospital ventilation data to predict intrathoracic pressure. Methods: Ventilation data from 108 TBI patients (76 ground transported, 32 helicopter transported) were used for this analysis. Ventilation rate (VR) and end-tidal carbon dioxide (PetCO2) values were used to estimate tidal volume (VT). The values for VR and estimated VT were then applied to a previously described mathematical model of perfusion and ventilation. This model allows various lung parameters to be defined to create a pr

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Background: Inadvertent hyperventilation is associated with poor outcomes from traumatic brain injury (TBI). Hypocapneic cerebral vasoconstriction is well described and causes an immediate and profound decrease in cerebral perfusion. The hemodynamic effects of positive-pressure ventilation (PPV) remain incompletely understood but may be equally important, particularly in the hypovolemic patient with TBI. Objective: To apply a previously described mathematical model of perfusion and ventilation to prehospital ventilation data to predict intrathoracic pressure. Methods: Ventilation data from 108 TBI patients (76 ground transported, 32 helicopter transported) were used for this analysis. Ventilation rate (VR) and end-tidal carbon dioxide (PetCO2) values were used to estimate tidal volume (VT). The values for VR and estimated VT were then applied to a previously described mathematical model of perfusion and ventilation. This model allows various lung parameters to be defined to create a pr

Keywords

MedicineTraumatic brain injuryAnesthesiaVentilation (architecture)Positive pressure ventilationRespiratory failure

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