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Metabolic and hemodynamic response to hyperventilation in patients with head injuries
Authors:E. Turner  O. Hilfiker  U. Braun  W. Wienecke  B. Rama
Affiliation:1. Centre for Anaesthesiology, University of G?ttingen School of Medicine, G?ttingen, FRG
2. Zentrum Anaesthesiologie, Universit?t G?ttingen, D-3400, G?ttingen, FRG
3. Neurological Medicine, University of G?ttingen School of Medicine, G?ttingen, FRG
Abstract:The effects of controlled moderate hyperventilation (paCo2∼31 mmHg) on cardiovascular parameters and whole-body-oxygen-uptake ( 
$$dot VO_2 $$
)was studied in 10 patients with head injuries, who were unconscious and artificially ventilated at the time of the investigation. 
$$dot VO_2 $$
was measured with the Beckmann Metabolic Measurement Cart and also calculated from cardiac output and arterio-mixed venous oxygen content difference. A mean increase in 
$$dot VO_2 $$
(+19.6% of control) was observed after 2 h of hyperventilation. Cardiac output remained unchanged. This resulted in a decrease of venous oxygen content and impaired full oxygenation of the blood. Our results indicate that hyperventilation should not be a routine procedure. Close monitoring of arterial and venous blood gases is recommended, when hyperventilation is applied.
Keywords:Brain injury  intracranial pressure  hyperventilation  whole-body-oxygen-uptake  alkalosis  oxygen extraction
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