Galán Fernández A, Fernández-Quero L, Navia J
Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital General Universitario Gregorio Marañón, Madrid.
Rev Esp Anestesiol Reanim. 2000 Jan;47(1):15-30.
Head injury is the main cause of death or disability among under-45-year-olds. This review covers the main pathophysiological aspects of head injury as well as initial treatment and management in the intensive care recovery ward. The chief therapeutic aim is to maintain adequate cerebral perfusion pressure rather than to maintain normal levels of intracranial pressure. An important challenge is to avoid development of secondary lesions, and in this context arterial hypotensive events that affect prognosis and the survival of such patients merit special attention. We reject treatment based on indiscriminate use of hyperventilation and mannitol and underline the importance of providing adequate sedation and analgesia while maintaining normal flow and pressure and adequate monitoring of such patients.
头部损伤是45岁以下人群死亡或致残的主要原因。本综述涵盖了头部损伤的主要病理生理学方面以及重症监护康复病房的初始治疗和管理。主要治疗目标是维持足够的脑灌注压，而非维持颅内压的正常水平。一个重要的挑战是避免继发性损伤的发生，在这种情况下，影响此类患者预后和生存的动脉性低血压事件值得特别关注。我们反对不加区分地使用过度通气和甘露醇进行治疗，并强调在维持此类患者正常血流和压力以及进行充分监测的同时，提供充分镇静和镇痛的重要性。
