Effect of positive end-expiratory pressure on intracranial pressure in dogs with intracerebral hematoma induced intracranial hypertension / 第三军医大学学报

ABSTRACT

Objective To evaluate the influence of positive end-expiratory pressure (PEEP) on intracranial pressure and cerebral perfusion pressure in dogs with or without intracranial hypertension caused by frontal intracerebral hematoma. Methods Eighteen dogs were randomly divided into three groups. In Group B and Group C, the intracranial hypertension was respectively higher than 25 mmHg but less than 40 mmHg and higher than 40 mmHg induced by autoblood clotting injection into the right frontal lobe, while Group A as control was of normal intracranial pressure. PEEP was applied in increment of 3 cmH2O from 0 to 18 cmH2O, each level lasting 20 min. The intracranial pressure (ICP) was monitored by an optical fiber transducer implanted into left frontal lobe. Mean arterial pressure (MAP), heart rate (HR), and central venous pressure (CVP) were recorded simultaneously. Cerebral perfusion pressure (CPP) was calculated by the equation (CPP=MAP-ICP). Results With increasing PEEP level, ICP increased and CPP fell in Group A; ICP fell, MAP and CPP increased in Group B; ICP fell, MAP and CPP increased in Group C. CVP increased in all groups, and the increment was significantly higher in Group C than the other two groups (P