Question

A patient who just suffered severe closed-head injury and has a high intracranial pressure (ICP) is about to be placed on ventilatory support. Which of the following strategies could help to lower the ICP?

a. Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation)
b. Allow as much spontaneous breathing as possible (SIMV)
c. Maintain a high mean pressure using PEEP levels of 10 to 15 cm H2O
d. Maintain a PaCO2 of 50 to 60 mm Hg (deliberate hypoventilation)

Answer 1

Hyperventilation by maintaining a PaCO2 from 25 to 30 mm Hg can lower intracranial pressure in a patient with severe closed-head injury.

Step-by-step explanation:

The strategy that could help lower intracranial pressure (ICP) in a patient with severe closed-head injury is (a) Maintain a PaCO2 from 25 to 30 mm Hg (deliberate hyperventilation). By hyperventilating, the patient breathes out more carbon dioxide (CO2) from their lungs, reducing the CO2 levels in the bloodstream. This causes vasoconstriction of the blood vessels in the brain, leading to reduced cerebral blood flow and decreased ICP.

On the other hand, hypoventilation (deliberate hypoventilation) would increase CO2 levels in the blood, leading to vasodilation of the brain blood vessels, increased cerebral blood flow, and higher ICP.