Optimizing Cerebral Perfusion Pressure During Fiberoptic Bronchoscopy in Severe Head Injury: Effect of Hyperventilation

Previgliano, Ignacio; Ripoll, P. I.; Chiappero, Guillermo; Galíndez, F.; Germani, Luigi; González, D. H.; Ferrari, Nicola; Hlavnicka, Alejandro; Purvis, Caitlin G

doi:10.1007/978-3-7091-6738-0_27

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Profound anaesthesia, including effective neuromuscular blockade, is often used in patients with head injury while undergoing bronchoscopy. Four studies (one randomised controlled trial270 and three others278 – 280) addressing this issue have consistently demonstrated that bronchoscopy raises ICP. A small but well conducted randomised study assessing hyperventilation via the ventilator during bronchoscopy demonstrated no difference in peak ICP,270 but suggested hyperventilation may accelerate return to baseline ICP after bronchoscopy in patients with closed head injury.…”

Section: Bronchoscopy In the Icumentioning

confidence: 99%

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

Rand

Blaikley

Booton

et al. 2013

Thorax

706

735

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Section: Bronchoscopy In the Icumentioning

confidence: 99%

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

Rand

Blaikley

Booton

et al. 2013

Thorax

706

735

View full text Add to dashboard Cite

“…Some reasons for the ICH by endotracheal suctioning may be the stimulation of the airways, which may be due to the cough reflex, as well as to the endotracheal tube and PEEP. [18][19][20][21][22] These procedures have been suggested that should be performed with anti-edema treatment in patients in ICU. It has emphasized that the need to determine appropriate analgesia and sedation regimens in order to reduce this effect.…”

Section: Discussionmentioning

confidence: 99%

Effect of bronchoscopy on intracranial hypertension during different regimen of sedation by optic nerve sheath diameter

Özsarı¹,

Demırhan²

2021

NeuroAsia

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Objectives: Fiberoptic bronchoscopy (FOB) is a useful method for ventilator-associated pneumonia (VAP), aspiration, and atelectasis, especially in intensive care units. (ICU) We aimed to investigate the effect of FOB on intracranial pressure by ultrasonographic optic nerve sheath diameter (uONSD) during different sedation protocols in a tertiary ICU. Methods: Prospective randomized study included the patients with two groups as superficial (Group M; midazolam) and deep sedation (Group P; propofol). FOB was performed for VAP or aspiration and intracranial hypertension (ICH) was measured with uONSD, noninvasively. The values of uONSD were noted pre-procedure, on sedation, 1st – 5th, and 15th minute of the procedure. In addition, mean arterial pressures (MAP), oxygen saturation, and heart rate values were recorded from the monitor. Results: The mean age and indications of FOB for 33 patients as Group M (n=17) and Group P (n=16) were similar to each other. ONSD was increased with the procedure in both groups but in group P it was stabilized from the 5th minutes of FOB whereas became higher progressively in group M (p<0,001). Postoperative MAP values that may have an important role for ICH were also increased in Group M (MAP was 70.65 ± 16.18 at time of sedation in Group P and 75.63 ± 13.76 in Group M). Conclusion: This study showed that bronchoscopy results as a significant increase for OSND in both groups but that was less high in patients who had deep sedation with propofol and it returned to baseline after the procedure.

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Hyperventilation therapy for acute traumatic brain injury

Roberts

Schierhout

1997

Cochrane Database of Systematic Reviews

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Optimizing Cerebral Perfusion Pressure During Fiberoptic Bronchoscopy in Severe Head Injury: Effect of Hyperventilation

Cited by 3 publications

References 7 publications

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE

Effect of bronchoscopy on intracranial hypertension during different regimen of sedation by optic nerve sheath diameter

Hyperventilation therapy for acute traumatic brain injury

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