Intraventricular Pressure in Non-communicating Hydrocephalus Patients Before Endoscopic Third Ventriculostomy

Werner Tiefenthaler; Johannes Burtscher; Patrizia L Moser; Ingo H Lorenz; Christian Kolbitsch

doi:10.1515/med-2019-0107

Intraventricular Pressure in Non-communicating Hydrocephalus Patients Before Endoscopic Third Ventriculostomy

Open Med (Wars). 2019 Nov 29:14:909-912. doi: 10.1515/med-2019-0107. eCollection 2019.

Authors

Werner Tiefenthaler¹, Johannes Burtscher², Patrizia L Moser³, Ingo H Lorenz⁴, Christian Kolbitsch⁴

Affiliations

¹ Department of Anaesthesia, Medalp Sportclinic, Imst, Austria.
² Department of Neurosurgery Landesklinikum Wiener, Neustadt, Austria.
³ Department of Pathology, Innpath GmbH, Innsbruck, Austria.
⁴ Department of Anaesthesia and Intensive Care Medicine, Innsbruck Medical University (MUI), Anichstrasse 35, A-6020 Innsbruck, Austria.

Abstract

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.

Keywords: Endoscopic third ventriculostomy; Hypercapnia; Intraventricular pressure.