| Title |
The Effect of Positive End-Expiratory Pressure on Intracranial Pressure and Cerebral Hemodynamics
|
|---|---|
| Published in |
Neurocritical Care, November 2016
|
| DOI | 10.1007/s12028-016-0328-9 |
| Pubmed ID | |
| Authors |
Myles D. Boone, Sayuri P. Jinadasa, Ariel Mueller, Shahzad Shaefi, Ekkehard M. Kasper, Khalid A. Hanafy, Brian P. O’Gara, Daniel S. Talmor |
| Abstract |
Lung protective ventilation has not been evaluated in patients with brain injury. It is unclear whether applying positive end-expiratory pressure (PEEP) adversely affects intracranial pressure (ICP) and cerebral perfusion pressure (CPP). We aimed to evaluate the effect of PEEP on ICP and CPP in a large population of patients with acute brain injury and varying categories of acute lung injury, defined by PaO2/FiO2. Retrospective data were collected from 341 patients with severe acute brain injury admitted to the ICU between 2008 and 2015. These patients experienced a total of 28,644 paired PEEP and ICP observations. Demographic, hemodynamic, physiologic, and ventilator data at the time of the paired PEEP and ICP observations were recorded. In the adjusted analysis, a statistically significant relationship between PEEP and ICP and PEEP and CPP was found only among observations occurring during periods of severe lung injury. For every centimeter H2O increase in PEEP, there was a 0.31 mmHg increase in ICP (p = 0.04; 95 % CI [0.07, 0.54]) and a 0.85 mmHg decrease in CPP (p = 0.02; 95 % CI [-1.48, -0.22]). Our results suggest that PEEP can be applied safely in patients with acute brain injury as it does not have a clinically significant effect on ICP or CPP. Further prospective studies are required to assess the safety of applying a lung protective ventilation strategy in brain-injured patients with lung injury. |
X Demographics
The data shown below were collected from the profiles of 9 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 44% |
| India | 1 | 11% |
| Ecuador | 1 | 11% |
| Unknown | 3 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 7 | 78% |
| Science communicators (journalists, bloggers, editors) | 1 | 11% |
| Scientists | 1 | 11% |
Mendeley readers
The data shown below were compiled from readership statistics for 140 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 140 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 16 | 11% |
| Student > Postgraduate | 15 | 11% |
| Other | 13 | 9% |
| Student > Bachelor | 12 | 9% |
| Professor > Associate Professor | 9 | 6% |
| Other | 31 | 22% |
| Unknown | 44 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 62 | 44% |
| Nursing and Health Professions | 11 | 8% |
| Neuroscience | 9 | 6% |
| Psychology | 2 | 1% |
| Engineering | 2 | 1% |
| Other | 5 | 4% |
| Unknown | 49 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2020.
All research outputs
#3,859,444
of 24,330,936 outputs
Outputs from Neurocritical Care
#347
of 1,622 outputs
Outputs of similar age
#59,639
of 311,046 outputs
Outputs of similar age from Neurocritical Care
#3
of 35 outputs
Altmetric has tracked 24,330,936 research outputs across all sources so far. Compared to these this one has done well and is in the 84th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,622 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.8. This one has done well, scoring higher than 78% of its peers.
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We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.