Cunitz G, Danhauser I, Gruss P
Anaesthesist. 1979 Mar;28(3):142-51.
The effects of a hyperventilation, positive negative pressure ventilation (PNPV) and ventilation using positive endexpiratory pressure (PEEP), on intracranial pressure (ICP) was measured in 24 patients suffering from different neurosurgical disorders. The patients were given a basic anaesthesia including muscle relaxation. The investigations showed, that hyperventilation, followed by a PCO2 of 26 and 30 torr, clearly lowered the intracranial pressure. The pressure drop was much more pronounced when the preexisting ICP was high than when it was low, due to the form of the compliance curve of the brain. PNPV also lowered intracranial pressure, but a harmful effect of this technique on lung function and structure is known. Its use is justified only for short periods and in addition to other measures for lowering ICP. The results also demonstrated that PNPV possesses limited beneficial properties with regard to the subject discussed here. Ventilation by PEEP significantly increased ICP. This technique is to be employed with caution in neurosurgery. Arterial pressure (radial artery) and central venous pressure (subclavian vein) were also recorded.
对24例患有不同神经外科疾病的患者测量了过度通气、正负压通气（PNPV）以及使用呼气末正压（PEEP）通气对颅内压（ICP）的影响。患者接受包括肌肉松弛在内的基础麻醉。研究表明，过度通气使二氧化碳分压（PCO2）降至26和30托时，能明显降低颅内压。由于脑顺应性曲线的形式，当原有颅内压较高时，压力下降比颅内压较低时更为显著。PNPV也能降低颅内压，但已知该技术对肺功能和结构有有害影响。仅在短期内且作为降低颅内压的其他措施的补充时，其使用才合理。结果还表明，就此处讨论的主题而言，PNPV的有益特性有限。PEEP通气显著增加颅内压。在神经外科手术中使用该技术时应谨慎。还记录了动脉压（桡动脉）和中心静脉压（锁骨下静脉）。
