创伤性脑损伤与航空医疗后送：何时适合飞行？
Traumatic brain injury and aeromedical evacuation: when is the brain fit to fly?
机构信息
Department of Surgery, University of Cincinnati Institute for Military Medicine (UCIMM), University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
出版信息
J Surg Res. 2010 Dec;164(2):286-93. doi: 10.1016/j.jss.2009.07.040. Epub 2009 Aug 26.
BACKGROUND
To review the inflammatory sequelae of traumatic brain injury (TBI) and altitude exposure and discuss the potential impact of aeromedical evacuation (AE) on this process.
METHODS
Literature review and expert opinion regarding the inflammatory effects of TBI and AE.
RESULTS
Traumatic brain injury has been called the signature injury of the current military conflict. As a result of the increasing incidence of blast injury, TBI is responsible for significant mortality and enduring morbidity in injured soldiers. Common secondary insults resulting from post-traumatic cerebral inflammation are recognized to adversely impact outcome. AE utilizing Critical Care Air Transport Teams has become a standard of care practice following battlefield injury, to quickly and safely transport critically injured soldiers to more sophisticated echelons of care. Exposure to the hypobaric conditions of the AE process may impose an additional physiologic risk on the TBI patient as well as a "second hit" inflammatory stimulus.
CONCLUSIONS
We review the known inflammatory effects of TBI and altitude exposure and propose that optimizing the post-traumatic inflammatory profile may assist in determining an ideal time to fly for head-injured soldiers.
背景
回顾创伤性脑损伤（TBI）和高原暴露的炎症后遗症，并讨论航空医疗后送（AE）对此过程的潜在影响。
方法
文献复习和专家意见，探讨 TBI 和 AE 的炎症影响。
结果
创伤性脑损伤已被称为当前军事冲突的标志性损伤。由于爆炸伤的发生率增加，TBI 导致受伤士兵的死亡率和持久发病率显著增加。公认的创伤后脑炎症的常见二次损伤会对预后产生不利影响。在战场受伤后，利用重症监护空运小组进行 AE 已成为护理标准，以便快速、安全地将重伤士兵转运至更高层次的医疗单位。AE 过程中低气压条件的暴露可能会对 TBI 患者造成额外的生理风险，以及“二次打击”炎症刺激。
结论
我们回顾了已知的 TBI 和高原暴露的炎症影响，并提出优化创伤后炎症谱可能有助于确定头部受伤士兵飞行的理想时间。
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