Background: Hyperventilation-induced hypocapnia (HV) reduces elevated intracranial pressure (ICP), a dangerous\nand potentially fatal complication of traumatic brain injury (TBI). HV decreases the arteriolar diameter of intracranial\nvessels, raising the risk of cerebral ischemia. The aim of this study was to characterize the effects of moderate shortterm\nHV in patients with severe TBI by using concomitant monitoring of cerebral metabolism, brain tissue oxygen\ntension (PbrO2), and cerebral hemodynamics with transcranial color-coded duplex sonography (TCCD).\nMethods: This prospective trial was conducted between May 2014 and May 2017 in the surgical intensive care unit\n(ICU) at the University Hospital of Zurich. Patients with nonpenetrating TBI older than 18 years of age with a\nGlasgow Coma Scale (GCS) score < 9 at presentation and with ICP monitoring, PbrO2, and/or microdialysis (MD)\nprobes during ICU admission within 36 h after injury were included in our study. Data collection and TCCD\nmeasurements were performed at baseline (A), at the beginning of moderate HV (C), after 50 min of moderate HV\n(D), and after return to baseline (E). Moderate HV was defined as arterial partial pressure of carbon dioxide 4-4.7 kPa.\nRepeated measures analysis of variance was used to compare variables at the different time points, followed by\npost hoc analysis with Bonferroni adjustment as appropriate.\nResults: Eleven patients (64% males, mean age.............
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