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AW: Head injury

Walter.Mauritz trauma-list@trauma.org
Wed, 9 Jan 2002 16:12:47 +0100 

Sara,
=20
If a patient does not respond to other measures (which you mentioned) t=
hen hyperventilation may be an option, but it should not be done withou=
t adequate monitoring of brain perfusion (i.e. monitoring of jugular bu=
lb oxygen saturation). In some patients intracranial hypertension may b=
e caused by "luxury perfusion" of the brain, and in these (who will hav=
e jugular bulb saturation values > 70), hyperventilation works very wel=
l.=20
=20
Best regards
=20
Walter

-----Urspr=FCngliche Nachricht-----
Von: Johnson, Sara [mailto:SJohnson@wtbyhosp.chime.org]
Gesendet am: Mittwoch, 9. Januar 2002 16:03
An: 'trauma-list@trauma.org'
Betreff: RE: Head injury

When I worked in the neuro unit here we used to hyperventilate to maint=
ain pCO2 levels <25mmHg.....which would definitely lower the ICP, but w=
ould then compromise the CPP.....according to current TNCC guidelines i=
t is recommended to attempt other measures first (sedation, paralysis, =
CSF drainage, and osmotic diuretics), then hyperventilate if ICP is ref=
ractory to these interventions
Sara Johnson, RN, MSN=20
ES Clinical Education Consultant=20
Waterbury Hospital Health Center=20
Waterbury, CT=20

-----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
=20
Hyperventilation leads to vasoconstriction - which leads to a reduction=
 in perfusion and cerebral ischaemia. =20
=20
You can have a 'play' with this on the website's neurotrauma physiology=
 simulator at:
=20
http://www.trauma.org/resus/neuromoulage/index.html <http://www.trauma.=
org/resus/neuromoulage/index.html>=20
=20
Karim
=20

-----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


=20
Can someone please tell me why hyperventilating head injury is "out" .
We are still told to do it..=20
Many thanks and Happy New Year,  Clive

=