Lodrini S, Montolivo M, Pluchino F, Borroni V
Department of Neurosurgery, Neurological Institute "C. Besta," Milan, Italy.
Neurosurgery. 1989 Jun;24(6):873-7. doi: 10.1227/00006123-198906000-00013.
The effects of positive end-expiratory pressure (PEEP) on central venous and intracranial (ICP) pressures were evaluated in 10 patients with posterior fossa tumors, in both supine and sitting positions. With patients in the supine position, intrathoracic PEEP-dependent venous hypertension was clearly transmitted to the intracranial compartment but without intracranial hypertension. On the contrary, with patients in the sitting position PEEP had no influence in almost half of our patients. In patients with radiological or clinical signs of increased ICP, however, the combination of head flexion and rotation with institution of PEEP caused a dangerous increase in ICP, even when the patients were in the sitting position. The need for early withdrawal of cerebrospinal fluid in these patients is stressed.
对10例后颅窝肿瘤患者在仰卧位和坐位时进行了呼气末正压通气（PEEP）对中心静脉压和颅内压（ICP）影响的评估。患者处于仰卧位时，胸腔内依赖PEEP的静脉高压明显传导至颅内腔，但未出现颅内高压。相反，在坐位患者中，几乎半数患者PEEP没有影响。然而，对于有影像学或临床ICP升高迹象的患者，即使患者处于坐位，头部屈曲和旋转联合应用PEEP也会导致ICP危险升高。强调了这些患者尽早进行脑脊液引流的必要性。
