Treatment of Spontaneous Hyperventilation With Remifentanil in Traumatic Brain Injury Patients

Launched by CAPITAL MEDICAL UNIVERSITY · Jul 13, 2021

Keywords

ClinConnect Summary

Severe Traumatic Brain Injury (sTBI) is a devastating disease with high hospital mortality and disability worldwide. For neurocritical care physicians, avoiding secondary brain injury remains the cornerstone of treatment in treating sTBI patients.

Carbon dioxide is a potent cerebral vascular modulator. By decreasing the arterial partial pressure of carbon dioxide (PaCO2), hyperventilation could induce cerebral vasoconstriction and decrease cerebral blood flow (CBF), which further reduces cerebral blood volume and lowering intracranial pressure. Traditionally, intentional hyperventilation w...

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Eligibility criteria

• Inclusion Criteria:
• • Age ≥ 18 years
• • Severe TBI (3 \< glasgow coma scale (GCS) ≤ 8)
• • Hyperventilation (PaCO2 \< 35 mmHg and pondus hydrogenii (pH) \> 7.45)
• • Presence of an endotracheal tube
• • Assisted ventilation mode (CPAP/PSV)
• Exclusion Criteria:
• • Induced/iatrogenic hyperventilation
• • No informed consent was signed
• • Transcranial doppler sonography (TCD) data collection cannot be completed due to anatomical structure
• • Severe multiple organ failure, persistent high fever, massive thoraco-peritoneal effusion
• • Medical history of major craniocerebral injury and chronic obstructive pulmonary disease (COPD)
• • Conformed or Suspected history of opioid-related adverse reactions
• • Withdraw from the study due to the change of patient's condition and other methods of treatment and intervention are needed