Anesthesia Considerations 

Ventilation therapies

 

• Severe TBI pts require definitive airway protection (risk pulm aspiration, compromised resp drive/fxn)

• Normal ventilation (w/ PaCO2 35-45 mmHg) is currently the goal in absence of cerebral herniation

• Prolonged prophylactic hyperventilation (PaCO2 ≤25 mmHg) not recommended

• Hyperventilation may be used as a temporizing measure to ↓ ICP (ex if cerebral herniation)

 

 

Adapted from Guidelines for the Management of Severe TBI, 4th Ed., September 2016, Brain Trauma Foundation.