Intracranial Pressure Responses During Hyperbaric Oxygen Therapy

概要

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The responses of intracranial pressure (ICP) to hyperbaric oxygen (HBO) therapy and arterial gas pressures were investigated. ICP was measured through a ventricular or spinal drainage catheter in patients with brain tumor or cerebrovascular disease. Changes in ICP, heart rate (HR), arterial blood pressure (ABP), and transcutaneous partial pressure of carbon dioxide (PtcCO_2) or oxygen (PtcO_2) were recorded continuously during air or 100% O_2 breathing at 1 and 2.5 atmospheres absolute (ATA). HR and PtcCO_2 decreased and mean ABP was unchanged during HBO inhalation. ICP was reduced at the beginning and tended to increase gradually during HBO inhalation. The change from air to O_2 without altering respiratory frequency and volume caused a gradual increase of ICP and PtcCO_2 with a transient ICP reduction in an artificially respirated patient. Intentionally reduced respiration to maintain PtcCO_2 at the value at 2.5 ATA with air caused the ICP to return to near the value at 2.5 ATA with air even during HBO inhalation. These findings suggest that reduced ICP is initially due to direct cerebral vasoconstriction caused by hyperoxia and is maintained mainly by induced hypocapnia during HBO inhalation. Care is required when giving HBO therapy to patients with a high ICP and/or who are respirated artificially.
日本脳神経外科学会の論文
1991-09-15