A survey of routine treatment of patients with intracranial hypertension (ICH) in specialized trauma centers in Sao Paulo, Brazil: a 11 million metropole!

Abstract

Objective: A survey of intensive care units (ICU) in São Paulo that care for patients with TBI and ICH using the hyperventilation technique.

Methods: A questionnaire was given to the physiotherapist coordinator at 57 hospitals in São Paulo, where 24-h neurosurgery service is provided.

Results: Fifty-one (89.5%) hospitals replied. From this total, thirty-four (66.7% perform the hyperventilation technique, 30 (85%) had the objective to reach values below 35 mmHg, four (11%) levels between 35 mmHg and 40 mmHg and one (3%) values over 40 mmHg.

Conclusions: We concluded that most hospitals in São Paulo perform hyperventilation in patients with severe brain trauma although there are not any specific Brazilian guidelines on this topic. Widespread controversy on the use of the hyperventilation technique in patients with severe brain trauma highlights the need for a specific Global policy on this topic.

Keywords: Hyperventilation; Intensive care units; Intracranial hypertension; Neurosurgery.