Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Interactive:
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Quiz
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Exams
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Critical Care Medicine


Answer 3
  1. It has no significant role except in certain patients who are deteriorating rapidly. Therapeutic hyperventilation using assisted mechanical ventilation (Paco2 < 25 mm Hg) was once considered a cornerstone in the management of TBI because it is causes a rapid reduction in ICP. However, hyperventilation reduces ICP by causing cerebral vasoconstriction with a subsequent reduction in cerebral blood flow. Studies have demonstrated that when hyperventilation is used in children with severe head injury, there is an increased risk of brain ischemia and worse neurologic outcomes. Based on this data, chronic hyperventilation is no longer recommended.5 Short-term hyperventilation, however, has a role in reducing ICP in patients who are rapidly deteriorating before other measures can be instituted.

    REFERENCE
    5. Bullock R, Chesnut R, Clifton G, et al. Guidelines for the management of severe head injury. New York: Brain Trauma Foundation; 1996.

Click here to return to the questions

 

Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj