Search

Byline: T. Bein (1), L.-P. Kuhr (1), S. Bele (2), F. Ploner (3), C. Keyl (1), K. Taeger (1) Keywords: Volume recruitment Brain injury Jugular venous oxygen saturation Abstract: Abstract Objective. To investigate the effects of a lung recruitment maneuver on intracranial pressure (ICP) and cerebral metabolism in patients with acute cerebral injury and respiratory failure. Design. Prospective investigation. Setting. Ten-bed intensive care unit of a university hospital. Patients. Eleven patients with acute traumatic or non-traumatic cerebral lesions, who were on mechanical ventilation with acute lung injury. Interventions. Hemodynamics, ICP, cerebral perfusion pressure (CPP), jugular venous oxygen saturation (SJO.sub.2), and arterial minus jugular venous lactate content difference (AJDL) were measured before, during and after a volume recruitment maneuver (VRM), which included a 30-s progressive increase in peak pressure up to 60 cm[H.sub.2]O and a sustained pressure at the same level for the next 30 s. Results. At the end of VRM, ICP was elevated (16+-5 mmHg vs 13+-5 mmHg before VRM, P Conclusions. Our VRM reduced cerebral hemodynamics and metabolism. We conclude that our VRM with high peak pressure effects only a marginal improvement in oxygenation but causes deterioration of cerebral hemodynamics. We therefore cannot recommend this technique for the ventilatory management of brain-injured patients. Author Affiliation: (1) Department of Anesthesia, University Hospital, 93042 Regensburg, Germany (2) Department of Neurosurgery, University Hospital, Regensburg, Germany (3) Department of Anesthesia, Hospital Sterzing, Italy Article History: Received Date: 19/10/2001 Accepted Date: 21/02/2002 Article note: Electronic Publication