Campbell R S, Hurst J M
Department of Surgery, University of Cincinnati Medical Center, Ohio, USA.
Respir Care Clin N Am. 1997 Mar;3(1):51-68.
Approximately 500,000 patients present with a CHI annually in the United States alone. Up to 20% of these injuries are classified as severe. Appropriate and aggressive intensive care of CHI patients will certainly reduce both the morbidity and mortality rates. Early therapy includes provision of adequate ventilation and oxygenation and definitive care based on clinical assessment. Once the acute phase of the injury has passed, supportive therapy should be maintained as long as secondary injury or complications are avoided. Respiratory care of CHI patients is important though different in each phase of the disease. Proper placement of and maintenance of airways, efficient use of and withdrawal from the mechanical ventilator, and providing adequate pulmonary toilet in order to treat or avoid pneumonia are but a few of the very important respiratory care practices necessary to provide optimal outcomes in patients with CHI.
仅在美国,每年就有大约50万名患者出现闭合性颅脑损伤(CHI)。这些损伤中高达20%被归类为严重损伤。对CHI患者进行适当且积极的重症监护肯定会降低发病率和死亡率。早期治疗包括提供足够的通气和氧合,并根据临床评估进行确定性治疗。一旦损伤的急性期过去,只要避免继发性损伤或并发症,就应维持支持性治疗。CHI患者的呼吸护理很重要,尽管在疾病的每个阶段都有所不同。正确放置和维护气道、有效使用和撤离机械通气机,以及提供足够的肺部清理以治疗或避免肺炎,这些都是为CHI患者提供最佳治疗效果所必需的非常重要的呼吸护理措施。