Indian Journal of Neurosurgery 2013; 02(03): 262-266
DOI: 10.4103/2277-9167.124232
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Mechanical ventilation in neurosurgical patients

Keshav Goyal
,
Ranadhir Mitra
,
Shweta Kedia
1   Department of Neurosurgery, Lady Harding Medical College, New Delhi, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

Publication Date:
18 January 2017 (online)

Abstract

Mechanical ventilation significantly affects cerebral oxygenation and cerebral blood flow through changes in arterial carbon dioxide levels. Neurosurgical patients might require mechanical ventilation for correction and maintenance of changes in the pulmonary system that occur either due to neurosurgical pathology or following surgery during the acute phase. This review discusses the basics of mechanical ventilation relevant to the neurosurgeon in the day-to-day management of neurosurgical patient requiring artificial support of the respiration.

 
  • References

  • 1 Georgiadis D, Schwarz S, Baumgartner RW, Veltkamp R, Schwab S. Influence of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure in patients with acute stroke. Stroke 2001; 32: 2088-2092
  • 2 Muench E, Bauhuf C, Roth H, Horn P, Phillips M, Marquetant N. et al Effects of positive end-expiratory pressure on regional cerebral blood flow, intracranial pressure, and brain tissue oxygenation. Crit Care Med 2005; 33: 2367-2372
  • 3 Caricato A, Conti G, Della Corte F, Mancino A, Santilli F, Sandroni C. et al Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: The role of respiratory system compliance. J Trauma 2005; 58: 571-576
  • 4 Salim A, Miller K, Dangleben D, Cipolle M, Pasquale M. High-frequency percussive ventilation: An alternative mode of ventilation for head-injured patients with adult respiratory distress syndrome. J Trauma 2004; 57: 542-546
  • 5 Jaskulka R, Weinstabl C, Schedl R. The course of intracranial pressure during respirator weaning after severe craniocerebral trauma. Unfallchirurg 1993; 96: 138-141
  • 6 Georgiadis D, Schwarz S, Kollmar R, Baumgartner RW, Schwab S. Influence of inspiration: Expiration ratio on intracranial and cerebral perfusion pressure in acute stroke patients. Intensive Care Med 2002; 28: 1089-1093
  • 7 Kerwin AJ, Croce MA, Timmons SD, Maxwell RA, Malhotra AK, Fabian TC. Effects of fiberoptic bronchoscopy on intracranial pressure in patients with brain injury: A prospective clinical study. J Trauma 2000; 48: 878-882
  • 8 Schierhout G, Roberts I. Hyperventilation therapy for acute traumatic brain injury. Cochrane Database Syst Rev 2000; 2: CD000566
  • 9 Susan LB, Randall MC, Jamshid G, Flora FM, Odette AH, Roger H. et al Hyperventilation. J Neurotrauma 2007; 24: S-87-S-90
  • 10 Susan LB, Randall MC, Jamshid G, Flora FM, Odette AH, Roger H. et al Guidelines for the management of severe traumatic brain injury, X. Brain oxygen monitoring and thresholds. J Neurotrauma 2007; 24: S-65-S-70
  • 11 Martini RP, Deem S, Treggiari MM. Targeting brain tissue oxygenation in traumatic brain injury. Respir Care 2013; 58: 162-172
  • 12 Como JJ, Sutton ER, McCunn M, Dutton RP, Johnson SB, Aarabi B. et al Characterizing the need for mechanical ventilation following cervical spinal cord injury with neurologic deficit. J Trauma 2005; 59: 912-916
  • 13 Winslow C, Rozovsky J. Effect of spinal cord injury on the respiratory system. Am J Phys Med Rehabil 2003; 82: 803-814
  • 14 Kearns M, Shimabukuro D. Respiratory complications and management of mechanical ventilation in cervical spine injury. ICU Dir 2012; 3: 220-223
  • 15 Peterson WP, Barbalata L, Brooks CA, Gerhart KA, Mellick DC, Whiteneck GG. The effect of tidal volumes on the time to wean persons with high tetraplegia from ventilators. Spinal Cord 1999; 37: 284-288
  • 16 Young N, Rhodes JK, Mascia L, Andrews PJ. Ventilatory strategies for patients with acute brain injury. Curr Opin Crit Care 2010; 16: 45-52
  • 17 Haddad SH, Arabi YM. Critical care management of severe traumatic brain injury in adults. Scand J Trauma Resusc Emerg Med 2012; 20: 12
  • 18 Baumann A, Audibert G, McDonnell J, Mertes PM. Neurogenic pulmonary edema. Acta Anaesthesiol Scand 2007; 51: 447-455
  • 19 Fletcher SJ, Atkinson JD. Use of prone ventilation in neurogenic pulmonary oedema. Br J Anaesth 2003; 90: 238-240
  • 20 MacIntyre NR. Evidence-based ventilator weaning and discontinuation. Respir Care 2004; 49: 830-836
  • 21 Coplin WM, Pierson DJ, Cooley KD, Newell DW, Rubenfeld GD. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. Am J Respir Crit Care Med 2000; 161: 1530-1536