Huseby J S, Luce J M, Cary J M, Pavlin E G, Butler J
J Neurosurg. 1981 Nov;55(5):704-5. doi: 10.3171/jns.1981.55.5.0704.
Positive end-expiratory pressure (PEEP) is used to improve oxygenation in patients with the adult respiratory distress syndrome. Nevertheless, this treatment may increase intracranial pressure (ICP) and be detrimental to certain neurosurgical patients. This clinical situation was simulated by administering PEEP to dogs with normal and elevated ICP. Increases in PEEP increased ICP in all animals. However, the presence of intracranial hypertension diminished the increase in ICP seen at a given level of PEEP. Cerebral perfusion pressure also fell less in the presence of intracranial hypertension than it did in the absence, although in the former situation cerebral perfusion pressure was at the lower limits of the range of cerebral autoregulation. These findings suggest that PEEP is no more detrimental to patients with elevated ICP than it is to patients whose ICP is normal, assuming that their cerebral autoregulation is not impaired.
呼气末正压（PEEP）用于改善成人呼吸窘迫综合征患者的氧合。然而，这种治疗可能会增加颅内压（ICP），对某些神经外科患者不利。通过对正常ICP和ICP升高的犬类给予PEEP来模拟这种临床情况。增加PEEP会使所有动物的ICP升高。然而，颅内高压的存在减少了在给定PEEP水平下观察到的ICP升高。与没有颅内高压的情况相比，存在颅内高压时脑灌注压下降也较少，尽管在前一种情况下脑灌注压处于脑自动调节范围的下限。这些发现表明，假设脑自动调节未受损，PEEP对ICP升高的患者并不比对ICP正常的患者更有害。
