Shapiro H M, Marshall L F
J Trauma. 1978 Apr;18(4):254-6. doi: 10.1097/00005373-197804000-00005.
PEEP (positive end-expiratory pressure) was required in 12 head-injured patients in whom intracranial pressure (ICP) monitoring had been previously established. In six, ICP increased by 10 mm Hg or more as 4-8 cm H2O of PEEP were administered. In 10 patients the mean arterial pressure decreased during PEEP. Before PEEP, the mean cerebral perfusion pressure (CPP = BP-ICP) was above 50 mm Hg in all patients. The CPP was less than 50 mm Hg in six patients given PEEP. Neurological deterioration occurred in two patients during PEEP therapy. In head-injured patients, optimal titration of PEEP therapy should include ICP measurement and/or continuous evaluation of neurologic status.
12例先前已进行颅内压（ICP）监测的头部受伤患者需要使用呼气末正压（PEEP）。其中6例在给予4 - 8厘米水柱的PEEP时，ICP升高了10毫米汞柱或更多。10例患者在使用PEEP期间平均动脉压下降。在使用PEEP之前，所有患者的平均脑灌注压（CPP = 血压 - ICP）均高于50毫米汞柱。给予PEEP的6例患者中CPP低于50毫米汞柱。2例患者在PEEP治疗期间出现神经功能恶化。对于头部受伤患者，PEEP治疗的最佳滴定应包括ICP测量和/或对神经状态的持续评估。
