Arbour Richard B
LaSalle University, Philadelphia, PA 19141, USA.
Crit Care Nurs Clin North Am. 2013 Jun;25(2):297-319. doi: 10.1016/j.ccell.2013.02.010. Epub 2013 Mar 29.
Traumatic brain injury, which may be blunt or penetrating, begins altering intracranial physiology at the moment of impact as primary brain trauma. This article differentiates blunt versus penetrating brain trauma, primary versus secondary brain injury, and subsequent intracranial pathophysiology. Discussion and case study correlate intracranial pathophysiology and multisystem influences on evolving brain injury with mechanism-based interventions to modulate brain components (brain, blood, and cerebrospinal fluid volumes). The discussion also explores the effects of controlled ventilation, cardiopulmonary physiology, and global physiologic state on secondary injury, control of intracranial pressure, and recovery.
创伤性脑损伤可分为钝器伤或穿透伤，在撞击瞬间作为原发性脑损伤开始改变颅内生理状态。本文区分了钝器伤与穿透伤性脑损伤、原发性与继发性脑损伤，以及随后的颅内病理生理学。讨论和案例研究将颅内病理生理学和多系统对不断发展的脑损伤的影响与基于机制的干预措施相关联，以调节脑成分（脑、血液和脑脊液容量）。讨论还探讨了控制性通气、心肺生理学和整体生理状态对继发性损伤、颅内压控制和恢复的影响。
