ESICM Talk: Episode 14

The manipulation of arterial carbon dioxide levels (PaCO2) is easy, and hyperventilation (HV) has been a common ICP-lowering strategy for over half a century. However, hyperventilation-induced vasoconstriction is a double-edged sword. It reduces cerebral blood volume and intracranial volume, and therefore, lowers ICP.

We observed huge variability among centres in PaCO2 values and use of HV. Although causal inferences cannot be drawn from these observational data, our results suggest that, in patients with severe intracranial hypertension, HV is not associated with worse long-term clinical outcome

In this episode, powered by the ICM Journal and ESICM NEXT, Laura Borgstedt interviews David Menon, among the authors who performed a secondary analysis of the CENTER-TBI study to describe current practice in PaCO2 management during the first week of ICU after TBI.