Hoff B H
Crit Care Med. 1978 Nov-Dec;6(6):366-9. doi: 10.1097/00003246-197811000-00004.
Near-hanging and strangulation injuries can result in multiorgan failure. A 13-year-old male sustained an ischemic anoxic cerebral injury that was followed by an encephalopathy lasting approximately 30 hours and pulmonary edema lasting more than 48 hours. The patient was treated with continuous positive pressure ventilation followed by spontaneous breathing with continuous positive airway pressure by a mask; shock was reversed. The loss of cardiovascular competency and pulmonary insufficiency are problems frequently encountered in the patient who has sustained an hypoxic insult. Cerebral injury can result from hypoxemia related to tracheal compression, aspiration, and pulmonary edema; cerebral vascular engorgement secondary to venous compression; and ischemic anoxia related to arterial compression. Cerebral changes continue after circulatory and pulmonary competence has been restored. Multiorgan monitoring and control including intracranial pressure monitoring may be required to guide therapy. Respiratory distress syndrome may develop secondary to multiple factors including autonomic reflexes triggered by cerebral hypoxia and edema.
缢颈和勒颈损伤可导致多器官功能衰竭。一名13岁男性遭受了缺血缺氧性脑损伤，随后出现持续约30小时的脑病和持续超过48小时的肺水肿。患者接受了持续正压通气治疗，随后通过面罩进行持续气道正压的自主呼吸；休克得到纠正。心血管功能丧失和肺功能不全是遭受缺氧损伤患者经常遇到的问题。脑损伤可由与气管压迫、误吸和肺水肿相关的低氧血症、静脉压迫继发的脑血管充血以及与动脉压迫相关的缺血缺氧引起。在循环和肺功能恢复后，脑部变化仍会持续。可能需要进行包括颅内压监测在内的多器官监测和控制以指导治疗。呼吸窘迫综合征可能继发于多种因素，包括由脑缺氧和水肿引发的自主反射。
