The use of mechanical hyperventilation in the treatment of elevated intracranial pressure is a well-established practice. We describe a patient with multiple trauma and a closed-head injury in whom conventional positive-pressure ventilation aggravated existing intracranial hypertension. High frequency jet ventilation was instituted, alleviating the undesirable effects of positive-pressure ventilation. Arterial blood gases improved during high frequency jet ventilation. High frequency jet ventilation may be the ventilatory method of choice in multiple-trauma victims with elevated intracranial pressure.
BeckerDP, MillerJD, WardJD. The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg. 1977;47:491–502.
6.
MillerJD, SullivanHG. Severe intracranial hypertension. In MillerJD, ed. International Anesthesiology Clinics. Boston: Little, Brown and Co; 1979:19–75.
7.
FrostEAM. The physiopathology of respiration in neurosurgical patients. J Neurosurg. 1979;50:699–714.
8.
HurstJM, SaulTG, DeHavenCB, BransonRD. High frequency jet ventilation used during mechanical hyperventilation to reduce ICP. Neurosurg (in press).
LassenNA. Control of cerebral circulation in health and disease. Circ Res. 1974;34:749–759.
16.
CarlonGC, KahnRC, HowlandWS, RayCJr. Clinical experience with high frequency jet ventilation: Theoretical considerations and clinical observations. Chest. 1982;81:350–359.
17.
BabinskiMF, AlbinM, SmithRB. Effect of high frequency ventilation in ICP (abstract). Crit Care Med. 1981;9:159.
18.
SchedlR, MuttzN, BenzerH, FasolP.Conventional mechanical ventilation versus high frequency ventilation-Influence on elevated intracranial pressure (abstract). Crit Care Med. 1984;12:263.
19.
BuneginL, BorgUR, HelselP, SjöstrandUH, AlbinMS, SmithRB. Cerebral blood flow during IPPV at normal and elevated ICP (abstract). Anesthesiology. 1982;57:A465.
20.
AuffantRA, ShuptrineJR, HotchkissRS, MaffeoCJ. Effects of HFV vs IPPV on cerebral perfusion pressure and cardiopulmonary function (abstract). Anesthesiology. 1982;57:A88.
21.
ToddMM, ToutantSM, ShapiroHM. The effects of high frequency positive pressure ventilation on intracranial pressure and brain movement in cats. Anesthesiology. 1981;54:496–504.
22.
HeardSO, BannerMJ, JaegerMJ. Airway pressure measurement during high frequency jet ventilation (abstract). Crit Care Med. 1984;12:262.
23.
O'DonnellJM, ThompsonDR, LaytonTR. The effect of high frequency jet ventilation on intracranial pressure in patients with closed head injuries. J Trauma. 1984;24:73–75.
24.
FrostEAM. Effects of positive end-expiratory pressure on intracranial pressure and compliance of brain-injured patients. J Neurosurg. 1977;47:195–200.
