Kannamani Balaji, Sahni Neeru, Bandyopadhyay Anjishnujit, Saini Vikas, Yaddanapudi Laxmi Narayana
Department of Critical Care Medicine, Manipal Hospital, Dwarka, New Delhi, India.
Department of Anaesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Anaesthesiol Clin Pharmacol. 2024 Oct-Dec;40(4):582-587. doi: 10.4103/joacp.joacp_249_23. Epub 2024 Jun 27.
Hanging is suspension of a person by noose or ligature around the neck. Hanging has been used as a judicial execution method since medieval times and is still a common method of suicide in developing countries. The term "near hanging" is used for those who survive long enough to reach the hospital, and these patients still hold mortality as high as 45%. These patients can present with a wide array of complaints involving cardiovascular, neurologic, and pulmonary systems and local injuries to the airway and vascular structures. High serum lactate and cardiac arrest at arrival are some of the prognostic factors which portend a poor prognosis. Early admission and aggressive treatment are essential to provide best neurologic outcome. Due to paucity of definitive guidelines, therapy has to be based on clinical reports and expertise of the treating physician. Hence, near-hanging patients pose a great challenge in primary emergency care and intensive care management. This review aims to outline the pathophysiology, prognostic indicators, and recent evidence in the management of near-hanging patients.
绞刑是指通过绳索或勒带套住颈部悬吊一个人。自中世纪以来，绞刑一直被用作一种司法处决方式，在发展中国家它仍是一种常见的自杀方式。“近乎绞死”一词用于指那些存活时间足够长并被送往医院的人，这些患者的死亡率仍高达45%。这些患者可能会出现涉及心血管、神经和肺部系统以及气道和血管结构局部损伤的各种各样的症状。高血清乳酸水平和入院时心脏骤停是一些预示预后不良的因素。早期入院和积极治疗对于获得最佳神经学结果至关重要。由于缺乏明确的指南，治疗必须基于临床报告和主治医生的专业知识。因此，近乎绞死的患者在初级急救护理和重症监护管理方面构成了巨大挑战。本综述旨在概述近乎绞死患者管理中的病理生理学、预后指标和最新证据。
