Intensive care management of arterial carbon dioxide in acute intracerebral haemorrhage: Case report of influences on cerebral haemodynamics

Abstract

Intracerebral haemorrhage is relatively common and has devastating consequences. Furthermore, non-invasive and invasive strategies to manage raised intracranial pressure remain limited and associated with high morbidity and mortality. We report a case of a 72-year-old male with intracerebral haemorrhage with ventricular extension, hydrocephalus and intracranial hypertension, who was evaluated by transcranial Doppler ultrasound and optic nerve sheath diameter. This case demonstrates that beyond pharmacological and surgical interventions, simple manipulation of arterial carbon dioxide has the propensity to improve cerebral haemodynamic parameters. Our results demonstrate the negative effects of hypercapnia on cerebral autoregulation and the benefits of having transcranial Doppler ultrasound available in the intensive care unit point of care.

POCUS, how can we include the brain? An overview

“…BU allows the evaluation of CA in both static and dynamic ways (Table 3). Analysis of CA is considered a pre-advanced skill [11]; however, the noninvasive and bedside characteristics of BU are essential for critical care patients, which entails a growing interest in this field, both in neurological [60][61][62][63] and general critical care patients [53,64,65].…”