{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:52:40Z","timestamp":1790639560379,"version":"4.1.0"},"reference-count":11,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1977,8]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Hypoxic pulmonary disorders and head injuries associated with increased intracranial pressure (ICP) frequently co-exist. Positive end-expiratory pressure (PEEP) improves hypoxemia but has been reported to impede cerebral venous return, potentially causing a further increase in ICP. This study examined the effects of PEEP on ICP at different levels of brain compliance.<\/jats:p>\n<jats:p content-type=\"fine-print\">Continuous ICP recordings were obtained after insertion of Scott cannulas to the lateral ventricles of seven comatose patients. Brain compliance was assessed by calculation of the pressure volume index. Patients were maintained in a 30\u00b0 head-up position. Maintenance of PEEP to levels of 40 cm H<jats:sub>2<\/jats:sub>O pressure for as long as 18 hours did not increase ICP in patients with either normal or low intracranial compliance, and did not increase ICP in the absence of pulmonary disease. Central venous pressure and pulmonary artery wedge pressure increased proportionately as PEEP was increased. No consistent changes were found in blood pressure recordings, nor were there any reductions in cardiac output found during the studies. Abrupt discontinuation of PEEP did not result in increased ICP except for a transient rise on two occasions when respiratory secretions became copious and the patients were inadequately ventilated. Improved oxygenation in two patients as a result of PEEP was concomitant with improved intracranial compliance and neurological status.<\/jats:p>\n<jats:p content-type=\"fine-print\">In patients with brain injuries, PEEP improves arterial oxygenation without increasing ICP as previously supposed. Consequently, PEEP is a valuable form of therapy for the comatose patient with pulmonary disorders such as pneumonia or pulmonary edema.<\/jats:p>","DOI":"10.3171\/jns.1977.47.2.0195","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:19:01Z","timestamp":1241709541000},"page":"195-200","source":"Crossref","is-referenced-by-count":96,"title":["Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients"],"prefix":"10.3171","volume":"47","author":[{"given":"Elizabeth A. M.","family":"Frost","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","first-page":"94","article-title":"Effects of positive end-expiratory pressure (PEEP) on intracranial pressure, sagittal sinus and cerebral perfusion pressures during experimental intracranial hypertension in cat.","author":"Aidinis","year":"1975"},{"key":"b2","series-title":"Inhal Ther","first-page":"47","article-title":"Effect of intermittent positive pressure breathing on cardiac output and splanchnic blood flow.","volume":"13","author":"Bashour","year":"1968"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3171\/jns.1976.45.1.0089","article-title":"Effects of central venous pressure on brain tissue pressure and brain volume.","volume":"45","author":"Cuypers","year":"1976"},{"key":"b4","series-title":"J Trauma","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1097\/00005373-197511000-00002","article-title":"Hemodynamic alterations with positive end-expiratory pressure: the contribution of the pulmonary vasculature.","volume":"15","author":"Hobelmann","year":"1975"},{"key":"b5","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"1430","DOI":"10.1056\/NEJM197012242832603","article-title":"Continuous positive pressure ventilation in acute respiratory failure. Effects on hemodynamics and lung function.","volume":"283","author":"Kumar","year":"1970"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"523","DOI":"10.3171\/jns.1975.43.5.0523","article-title":"Compartmental analysis of compliance and outflow resistance of the cerebrospinal fluid system.","volume":"43","author":"Marmarou","year":"1975"},{"key":"b7","author":"Marmarou"},{"key":"b8","series-title":"Can Anaesth Soc J","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1007\/BF03023865","article-title":"Cerebrospinal fluid pressures during halothane anesthesia.","volume":"9","author":"Marx","year":"1962"},{"key":"b9","series-title":"Respir Care","first-page":"173","article-title":"Improvement of oxygenation in the adult respiratory distress syndrome by PEEP.","volume":"16","author":"Petty","year":"1971"},{"key":"b10","series-title":"Anesthesiology","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/00000542-197201000-00002","article-title":"The response of brain surface pressure to hypercapnic hypoxia and hyperventilation.","volume":"36","author":"Schettini","year":"1972"},{"issue":"3","key":"b11","series-title":"Surg Clin North Am","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/S0039-6109(16)40631-6","article-title":"Use of balloon flotation catheters in critically ill patients.","volume":"55","author":"Swan","year":"1975"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/47\/2\/article-p195.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/47\/2\/article-p195.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/47\/2\/article-p195.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T13:52:16Z","timestamp":1666533136000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/47\/2\/article-p195.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1977,8]]},"references-count":11,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/jns.1977.47.2.0195","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1977,8]]}}}