Effects of positive end-expiratory pressure on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in acute brain injury:Friend or foe?A scoping review

作     者：Greta Zunino Denise Battaglini Daniel Agustin Godoy Greta Zunino;Denise Battaglini;Daniel Agustin Godoy

作者机构：IRCCS Ospedale Policlinico San MartinoGenovaItaly Dipartimento di Scienze Diagnostiche e Chirurgiche IntegrateUniversitàdegli Studi di GenovaGenovaItaly Neurointensive Care UnitSanatorio PasteurCatamarcaArgentina 

出 版 物：《Journal of Intensive Medicine》 (重症医学（英文）)

年 卷 期：2024年第4卷第2期

页      面：247-260页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This research did not receive any specific grant from funding agencies in the public  commercial  or not-for-profit sectors 

主　　题：Acute brain injury Mechanical ventilation Positive end-expiratory pressure Intracranial pressure Brain-lung crosstalk Multimodal monitoring 

摘      要：Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk *** patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the *** The five-stage paradigm devised by Peters et *** expanded by Arksey and O Malley,Levac et al.,and the Joanna Briggs Institute was used for *** also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension *** criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with *** criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete *** authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online *** were presented in narrative and tubular *** The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion *** has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoi