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Effects of hyperbaric oxygen on intracranial pressure and cerebral blood flow in experimental cerebral oedema
  1. J. D. Miller2,
  2. I. McA. Ledingham,
  3. W. B. Jennett
  1. Hyperbaric Unit, University Department of Surgery, Western Infirmary, Glasgow.
  2. The University Department of Neurosurgery, Institute of Neurological Sciences, Glasgow.

    Abstract

    Increased intracranial pressure was induced in anaesthetized dogs by application of liquid nitrogen to the dura mater. Intracranial pressure and cerebral blood flow were measured, together with arterial blood pressure and arterial and cerebral venous blood gases.

    Carbon dioxide was administered intermittently to test the responsiveness of the cerebral circulation, and hyperbaric oxygen was delivered at intervals in a walk-in hyperbaric chamber, pressurized to two atmospheres absolute.

    Hyperbaric oxygen caused a 30% reduction of intracranial pressure and a 19% reduction of cerebral blood flow in the absence of changes in arterial PCO2 or blood pressure, but only as long as administration of carbon dioxide caused an increase in both intracranial pressure and cerebral blood flow. When carbon dioxide failed to influence intracranial pressure or cerebral blood flow then hyperbaric oxygen had no effect. This unresponsive state was reached at high levels of intracranial pressure.

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    Footnotes

    • 2 Present address: Division of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, U.S.A.

    • 1 This work has been supported by the Medical Research Council. J.D.M. was in receipt of a Medical Research Council Fellowship.