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  • 标题:Airway management of patients with traumatic brain injury/C-spine injury
  • 本地全文:下载
  • 作者:Jung, Jin Yong
  • 期刊名称:Korean Journal of Anesthesiology
  • 印刷版ISSN:2005-6419
  • 出版年度:2015
  • 卷号:68
  • 期号:3
  • 页码:213-219
  • DOI:10.4097/kjae.2015.68.3.213
  • 语种:English
  • 出版社:The Korean Society of Anesthesiologists,
  • 摘要:

    Traumatic brain injury (TBI) is usually combined with cervical spine (C-spine) injury. The possibility of C-spine injury is always considered when performing endotracheal intubation in these patients. Rapid sequence intubation is recommended with adequate sedative or analgesics and a muscle relaxant to prevent an increase in intracranial pressure during intubation in TBI patients. Normocapnia and mild hyperoxemia should be maintained to prevent secondary brain injury. The manual-in-line-stabilization (MILS) technique effectively lessens C-spine movement during intubation. However, the MILS technique can reduce mouth opening and lead to a poor laryngoscopic view. The newly introduced video laryngoscope can manage these problems. The AirWay Scope® (AWS) and AirTraq laryngoscope decreased the extension movement of C-spines at the occiput-C1 and C2-C4 levels, improving intubation conditions and shortening the time to complete tracheal intubation compared with a direct laryngoscope. The Glidescope® also decreased cervical movement in the C2-C5 levels during intubation and improved vocal cord visualization, but a longer duration was required to complete intubation compared with other devices. A lightwand also reduced cervical motion across all segments. A fiberoptic bronchoscope-guided nasal intubation is the best method to reduce cervical movement, but a skilled operator is required. In conclusion, a video laryngoscope assists airway management in TBI patients with C-spine injury.

  • 关键词:airway management; Cervical cord; Intubation; Traumatic brain injury
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