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Wed, 9 Jan 2002 10:02:49 -0500

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When I worked in the neuro unit here we used to hyperventilate to maintain
pCO2 levels <25mmHg.....which would definitely lower the ICP, but would then
compromise the CPP.....according to current TNCC guidelines it is
recommended to attempt other measures first (sedation, paralysis, CSF
drainage, and osmotic diuretics), then hyperventilate if ICP is refractory
to these interventions
Sara Johnson, RN, MSN 
ES Clinical Education Consultant 
Waterbury Hospital Health Center 
Waterbury, CT 

-----Original Message-----
From: Karim Brohi [mailto:karim@trauma.org]
Sent: Tuesday, January 08, 2002 5:50 PM
To: trauma-list@trauma.org
Subject: RE: Head injury

Clive

Hyperventilation leads to vasoconstriction - which leads to a reduction in
perfusion and cerebral ischaemia.  

You can have a 'play' with this on the website's neurotrauma physiology
simulator at:

http://www.trauma.org/resus/neuromoulage/index.html
<http://www.trauma.org/resus/neuromoulage/index.html> 

Karim

-----Original Message-----
From: trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]On
Behalf Of Clive Leach
Sent: 07 January 2002 11:40
To: trauma-list@trauma.org
Subject: Head injury

Can someone please tell me why hyperventilating head injury is "out" .
We are still told to do it.. 
Many thanks and Happy New Year,  Clive

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<DIV><SPAN class=990035714-09012002><FONT face=Arial color=#0000ff size=2>When I 
worked in the neuro unit here we used to hyperventilate to maintain pCO2 levels 
&lt;25mmHg.....which would definitely lower the ICP, but would then compromise 
the CPP.....according to current TNCC guidelines it is recommended to attempt 
other measures first (sedation, paralysis, CSF drainage, and osmotic diuretics), 
then&nbsp;hyperventilate if ICP is refractory to these 
interventions</FONT></SPAN></DIV>
<DIV><SPAN class=990035714-09012002>
<P><FONT face=Fixedsys color=#800080 size=2>Sara Johnson, RN, MSN</FONT> 
<BR><FONT face=Fixedsys color=#800080 size=2>ES Clinical Education 
Consultant</FONT> <BR><FONT face=Fixedsys color=#800080 size=2>Waterbury 
Hospital Health Center</FONT> <BR><FONT face=Fixedsys color=#800080 
size=2>Waterbury, CT</FONT> </P></SPAN></DIV>
<BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
  <DIV class=OutlookMessageHeader><FONT face="Times New Roman" 
  size=2>-----Original Message-----<BR><B>From:</B> Karim Brohi 
  [mailto:karim@trauma.org]<BR><B>Sent:</B> Tuesday, January 08, 2002 5:50 
  PM<BR><B>To:</B> trauma-list@trauma.org<BR><B>Subject:</B> RE: Head 
  injury<BR><BR></FONT></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2>Clive</FONT></SPAN></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2>Hyperventilation leads to vasoconstriction - which leads to a reduction 
  in perfusion and cerebral ischaemia.&nbsp; </FONT></SPAN></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff size=2>You can have a 
  'play' with this on the website's neurotrauma physiology simulator 
  at:</FONT></SPAN></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff size=2><A 
  href=http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2002/"http://www.trauma.org/resus/neuromoulage/index.html">http://www.trauma.org/resus/neuromoulage/index.html</A></FONT></SPAN></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2>Karim</FONT></SPAN></DIV>
  <DIV><SPAN class=999194722-08012002><FONT color=#0000ff 
  size=2></FONT></SPAN>&nbsp;</DIV>
  <BLOCKQUOTE dir=ltr style="MARGIN-RIGHT: 0px">
    <DIV class=OutlookMessageHeader dir=ltr align=left><FONT face=Tahoma 
    size=2>-----Original Message-----<BR><B>From:</B> 
    trauma-list-admin@trauma.org [mailto:trauma-list-admin@trauma.org]<B>On 
    Behalf Of </B>Clive Leach<BR><B>Sent:</B> 07 January 2002 
    11:40<BR><B>To:</B> trauma-list@trauma.org<BR><B>Subject:</B> Head 
    injury<BR><BR></FONT></DIV>
    <DIV><FONT face=Arial size=2></FONT>&nbsp;</DIV>
    <DIV><FONT face=Arial size=2>Can someone please tell me why hyperventilating 
    head injury is "out" .</FONT></DIV>
    <DIV><FONT face=Arial size=2>We are still told to do it.. </FONT></DIV>
    <DIV><FONT face=Arial size=2>Many thanks and Happy New Year,&nbsp; 
    Clive</FONT></DIV></BLOCKQUOTE></BLOCKQUOTE></BODY></HTML>

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