Which of the following procedure or activities can cause an increased intracranial pressure? I. obtaining an arterial blood sample from an arterial line II. increasing the delivered Fio2 III. endotracheal suctioning IV. airway manipulation
A. I, IV only
B. III, IV only
C. I, III, IV only
D. II, III, IV only
ANS: B
A. Incorrect response: See explanation B.
B. Correct response: Positive-pressure ventilation can have a detrimental effect on the CPP if the ventilatory strategies lead to either a rise in ICP or a drop in MAP. Performing endotracheal suctioning, coughing, and manipulating airway pressure can induce a rise in ICP. Positive-pressure ventilation and PEEP tend to decrease venous return to the right ventricle, which can lead to a decrease in the MAP.
C. Incorrect response: See explanation B.
D. Incorrect response: See explanation B.?
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