A 36-year-old patient was admitted for cerebral hemorrhage, open to ventricles.
Neurosurgical evacuation was ruled out.
Initially it presents ICP above 20mmHg; sedoanalgesia, relaxation and osmotic start.
At 72h, progressive respiratory deterioration was attributed to neurogenic pulmonary edema.
After 48h, FiO2 of 1 was established on day 8 of admission.
There is no relevant respiratory improvement and ICP rises to 20mmHg.
After 12h, she goes back to DS.
After 12h more, respiratory improvement is started, which allows a decrease in FiO2.
The twelfth day, coinciding with a transfer to the CT room, ICP monitoring is lost and a new sensor is placed, which offers values below 20mmHg, with successively maintaining CPP above 65mmHg.
Two days later she deteriorates again respiratoryly.
It is placed early in PD, allowing a decrease in FiO2 in 3h.
After 12h in PD, it is placed in SD and the improvement is maintained.
No deterioration of ICP or CPP was observed.
The subsequent evolution is favorable until recovery of a normal level of consciousness with left hemiparesis.
