RepercussÃo da pressÃo positiva expiratÃria final na pressÃo de perfusÃo cerebral em pacientes adultos com acidente vascular cerebral hemorrÃgico na fase aguda

AUTOR(ES)

Wildberg Alencar Lima

DATA DE PUBLICAÇÃO

2009

RESUMO

Intrathoracic positive pressure may lead to a change hemodynamics, with repercussions for the intracranial compartment, thereby altering intracranial pressure (ICP) and cerebral perfusion pressure (CPP). This effect may become more intense when using high positive end expiratory pressure (PEEP) values. The aim of the present study was to measure the impact of different PEEP values on ICP, CPP and mean arterial pressure (MAP). The study was carried out at a neurological intensive care unit and involved 25 patients with hemorrhage stroke under mechanical ventilation in the airway pressure control mode. No patient exhibited low complacency of the respiratory system. PEEP values ranging from 0 to 14 cmH2O were administered randomly by lots varying every 2 cmH2O. Monitoring of ICP, CPP and MAP occurred after five minutes at each PEEP level. The results demonstrate that the increase in PEEP led to an increase in ICP (p <0.001), but no change in CPP or MAP. The findings reveal that PEEP values as high as 14 cmH2O in hemorrhage stroke victims do not affect CPP or MAP, whereas high PEEP values increase ICP, although without clinical relevance

ASSUNTO(S)

neurologia pressÃo intracraniana cerebral perfusion pressure positive end expiratory pressure pressÃo positiva expiratÃria final intracranial pressure pressÃo de perfusÃo cerebral

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