Hyperventilation for Intracranial Pressure

A recent study implemented in a Swedish neuro ICU suggests that 30-34mmHg hyperventilation is beneficial for patients diagnosed with severe TBI due to potential improvements in pressure autoregulation. The study was carried out between 2008 and 2018 and included 120 patients whose arterial pCO2, PRx55-15, as well as the level of glucose, lactate, and pyruvate, were examined for three days right after TBI. It was also found that 30-34mmHg hyperventilation and younger age were related to better pressure reactivity index. Older age and 20mmHg hyperventilation were associated with higher levels on the first and third days, and lower levels on the second day. Lower pCO2 was associated with higher levels of cerebral pyruvate, while no changes in cerebral glucose, lactate, or LPR levels were identified. Hence, the study suggests that mild hyperventilation is safe until the normalization of ICP. Nevertheless, according to the lecture, hyperventilation should be utilized only in case other methods are unavailable. I will not recommend this therapy to prevent possible injuries.