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Author Question: In which of the following situations should iatrogenic hyperventilation be considered? a. Severe ... (Read 25 times)

j.rubin

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on: Jul 16, 2018
In which of the following situations should iatrogenic hyperventilation be considered?
 
  a. Severe traumatic brain injury
  b. Initial treatment for increased intracranial pressure
  c. Acute head injuries with increased intra-cranial pressure
  d. Acute neurological deterioration with in-creased intracranial pressure

Question 2

Permissive hypercapnia could benefit patients with which of the following?
 
  a. Cerebral trauma
  b. Intracranial lesion
  c. Acute lung injury
  d. Cardiovascular instability


sultansheikh

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Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: D
Hyperventilation may be needed for brief periods when acute neurological deterioration is pre-sent and the ICP is elevated. Current therapeutic guidelines for head injuries with increased ICP do not recommend prophylactic hyperventilation (PaCO2 < 25 mm Hg) during the first 24 hours. Hyperventilation during the first few days after severe traumatic brain injury (TBI) may actually increase cerebral ischemia and cause cerebral hypoxemia.

Answer to Question 2

ANS: C
Patients with ALI benefit from permissive hypercapnia to protect the lungs from ventila-tor-induced lung injury. Contraindications to PHY include cerebral disorders, because CO2 is a powerful vasodilator. PHY is also contraindicated in patients with preexisting cardiovascular in-stability, because the circulatory effects of PHY can include decreased myocardial contractility, arrhythmias, vasodilation, and increased sympathetic activity.


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