Intraventricular pressure in non-communicating hydrocephalus patients before endoscopic third ventriculostomy

Author:

Tiefenthaler Werner1,Burtscher Johannes2,Moser Patrizia L.3,Lorenz Ingo H.4,Kolbitsch Christian4

Affiliation:

1. Department of Anaesthesia, Medalp Sportclinic, Imst, Austria

2. Department of Neurosurgery Landesklinikum Wiener, Neustadt, Austria

3. Department of Pathology, Innpath GmbH, Innsbruck, Austria

4. Department of Anaesthesia and Intensive Care Medicine, Innsbruck Medical University (MUI), Anichstrasse 35, A-6020 Innsbruck, Austria

Abstract

AbstractBackgroundIn patients with non-communicating hydrocephalus impairment of cerebral compliance can occur pre- but also intraoperatively.MethodologyIn such patients (n = 6) undergoing endoscopic third ventriculostomy (ETV), the present study aimed to investigate the effect of ETCO2 (e.g 40 mmHg and 60 mmHg) and positive end-expiratory pressure (PEEP) (e.g. 6 cm and 12 cm H2O) on intraventricular pressure (IVP).FindingsBefore but not after ETV, hypercapnia in contrast to PEEP increased IVP(before ETV(PEEP-6/ ETCO2-40: 2.6 ± 2.4 mmHg) vs. (PEEP-6/ ETCO2-60: 12 ± 6.4 mmHg*); (PEEP-12/ ETCO2-40: 4.2 ± 4.1 mmHg) vs. (PEEP-12/ ETCO2-60: 13.7 ± 7.6 mmHg*), * significant, P ≤ 0.05;after ETV(PEEP-6/ ETCO2-40: 2.0 ± 1.2 mmHg) vs. (PEEP-6/ ETCO2-60: 4.4 ± 3.1 mmHg); (PEEP-12/ ETCO2-40: 1.6 ± 1.3 mmHg) vs. (PEEP-12/ ETCO2-60: 6.6 ± 2.6 mmHg), * significant, P ≤ 0.05).ConclusionPatients with non-communicating hydrocephalus showed that hypercapnia but not PEEP increases significantly IVP before but not after ETV.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

Reference42 articles.

1. Cardiovascular changes during endoscopic third ventriculostomy;Minim Invasive Neurosurg,2003

2. The impact of hypercapnia on systolic cerebrospinal fluid peak velocity in the aqueduct of sylvius;Anesth Analg,2002

3. Influence of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure in patients with acute stroke;Stroke,2002

4. Effect of propofol and clonidine on cerebral blood flow velocity and carbon dioxide reactivity in the middle cerebral artery;J Neurosurg Anesthesiol,2004

5. End-tidal carbon dioxide measurement in infants and children during and after general anaesthesia;Can J Anaesth,1994

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