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Intraventricular Pressure in Non-communicating Hydrocephalus Patients Before Endoscopic Third Ventriculostomy
Werner Tiefenthaler1, Johannes Burtscher2, Patrizia L Moser3
1Department of Anaesthesia, Medalp Sportclinic, Imst, Austria.
Background:
In patients with non-communicating hydrocephalus impairment of cerebral compliance can occur pre- but also intraoperatively.
Methodology:
In such patients (n = 6) undergoing endoscopic third ventriculostomy (ETV), the present study aimed to investigate the effect of ETCO2 (e.g 40 mmHg and 60 mmHg) and positive end-expiratory pressure (PEEP) (e.g. 6 cm and 12 cm H2O) on intraventricular pressure (IVP).
Findings:
Before but not after ETV, hypercapnia in contrast to PEEP increased IVP.
Before Etv:
(PEEP-6/ ETCO2-40: 2.6 ± 2.4 mmHg) vs. (PEEP-6/ ETCO2-60: 12 ± 6.4 mmHg*); (PEEP-12/ ETCO2-40: 4.2 ± 4.1 mmHg) vs. (PEEP-12/ ETCO2-60: 13.7 ± 7.6 mmHg*), * significant, P ≤ 0.05.
After Etv:
(PEEP-6/ ETCO2-40: 2.0 ± 1.2 mmHg) vs. (PEEP-6/ ETCO2-60: 4.4 ± 3.1 mmHg); (PEEP-12/ ETCO2-40: 1.6 ± 1.3 mmHg) vs. (PEEP-12/ ETCO2-60: 6.6 ± 2.6 mmHg), * significant, P ≤ 0.05).
Conclusion:
Patients with non-communicating hydrocephalus showed that hypercapnia but not PEEP increases significantly IVP before but not after ETV.
