The effect of respiratory therapy on intracranial pressure in ventilated neurosurgical patients.

Considerable concern has been expressed about the effect of respiratory therapy on intracranial pressure (I.C.P.) in the acute stage of head injury. A study was performed to evaluate the effects of respiratory therapy techniques on the level of I.C.P. in neurosurgical patients. Twenty subjects were studied in both the paralysed and non-paralysed states. Their intracranial pressures were monitored during periods of no treatment (the control), during the application of individual respiratory techniques and during a complete respiratory treatment. Analyses revealed that total treatment time is a crucial factor in the level of I.C.P. Patients with a high resting I.C.P. are more vulnerable to large increases, prolonged manual hyperinflation raises I.C.P. level and suctioning, in particular, causes dramatic increases in I.C.P.