CO2 and ventilation strategy in neuro cases

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Here's a brief summary of the Neuro categories.

Factors that determine ICP

Munroe kellie doctrine: 

Brain

CSF

Blood

·      Metabolic  - pH, BSL

·      Co2

·      O2

·      nervous

·      Venous outflow

·      Sneezing cough

In Practice I convert the above into these catergories

Blood

Physical – loosen ETT ties, collar, head up, minimise PEEP and paralyse patient

Physiological – normal CO2, O2, pH, BSL,  BP

Pharmacological – mannitol, hypertonic saline

CSF

Drain it

Brain

Surgical resection 

Craniectomy 

Functions of CSF

BC PAINT 

Buffers ICP

Constant ionic environment 

Protective

Acid base

Interstitial proteins

Nutrition

Toxin removal 

Neuroendocrine function of brain

http://blog.cambridgecoaching.com/essential-tips-for-learning-the-anterior-pituitary-hormones

Ant pituitary

FLAT PEG

FSH

LH

ACTH

TSH

prolactin

Endorphins

GH

Post pit

Vasopressin

Oxytocin

Pineal gland

Melatonin

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