Head Injury and Hyperventilation

Published

Hi all, Just wanted to see if this is a common theme across facilities. I have noticed there is a tendency both pre-hospital and in Emergency to hyperventilate / hyperoxygenate patients with traumatic brain injuries. I understand the theoretical benefits but most recent research suggests we should only do this in the context of suspected herniation and even then, could be making things worse. I have noticed that this practise is common whether the patient has focal signs or not. Is this something that is common elsewhere? Even mandated? Am thinking of putting together an observational study but it will need to be multi-facility. Thankyou AN ED masters.

Keep the PaCO2 between 30 and 35 mm Hg for the first 24 hours..... it is fine to hyperventilate with a goal of maintaining an ETCO2 30-35 mm Hg and discontinue when signs of herniation are alleviated.

I am having trouble finding reference to these exact numbers in the guidelines you mentioned. It would help me tremendously if you could direct me to something that references 30-35 specifically. Thanks!!

Up Vote Up Vote ×
Specializes in Emergency, Haematology/Oncology.

anectodally, women tend to be on the receiving end of "over" ventilating for obvious reasons.

/quote]

i am not sure what the obvious reasons are? what am i missing? otherwise very helpful information.

just generally smaller lungs:)

Up Vote Up Vote ×
+ Join the Discussion