Mao Xiongyan, Zhou Yuchan, Chen Qiye, Zhang Yelei
Department of Neurosurgery, Xishan People's Hospital of Wuxi City, Wuxi Branch of Zhongda Hospital Southeast University, Wuxi, China.
Front Neurol. 2024 Dec 20;15:1455926. doi: 10.3389/fneur.2024.1455926. eCollection 2024.
Tracheostomy is a routine surgical procedure in patients with severe traumatic brain injury, which requires mechanical ventilation to maintain gas exchange and avoid hypoxemia. Inadequate tracheostomy timing, nursing care, and decannulation would lead to a series of complications, such as aggravated pneumonia and prolonged intubation. The effects of early tracheostomy versus late tracheostomy have been explored. And early tracheostomy is more likely associated with shorter hospital stays and fewer complications. But the relevant reports are controversial. A safe and fast tracheostomy decannulation would facilitate the recovery. However, there was a broad variability in the indications and timing of tracheostomy and decannulation. High-quality evidence is subsequently lacking. We conducted this review to address gaps in knowledge regarding the management strategy and nursing protocol in patients with tracheostomy and decannulation following traumatic brain injury. A multidisciplinary tracheostomy team containing nursing care was also discussed to provide the best service to these patients.
气管切开术是重度创伤性脑损伤患者的常规外科手术，这类患者需要机械通气来维持气体交换并避免低氧血症。气管切开时机不当、护理及拔管操作会导致一系列并发症，如加重肺炎和延长插管时间。人们已经探讨了早期气管切开与晚期气管切开的效果。早期气管切开更有可能缩短住院时间并减少并发症。但相关报告存在争议。安全快速的气管切开拔管有助于康复。然而，气管切开和拔管的适应证及时机差异很大。随后缺乏高质量证据。我们进行这项综述以填补创伤性脑损伤后气管切开和拔管患者管理策略及护理方案方面的知识空白。还讨论了一个包含护理的多学科气管切开团队，以便为这些患者提供最佳服务。
