The Use of Quantitative End-Tidal Capnometry to Avoid Inadvertent Severe Hyperventilation in Patients With Head Injury After Paramedic Rapid Sequence Intubation

摘要

The ability of hyperventilation to lower omtracramoa; [ressire (ICP) via a decrease in cerebral blood volume is well documented. However, hyperventilation may lead to an even greater decrease in cerebral perfusion, resulting in ischemia.1"9 Clinical evidence suggests that empiric hyperventilation worsens neurologic outcome, and current treatment guidelines recommend avoidance of hyperventilation except in cases of severe refractory intracranial hypertension or in the case of signs and symptoms that presage impend-ing herniation.10'11 Despite these recommendations, however, multiple studies have documented a high incidence of inadvertent hyperventilation in critically ill patients, especially in the prehospital environment.