Airway management of patients with traumatic brain injury/C-spine injury / 대한마취과학회지
Korean Journal of Anesthesiology
; : 213-219, 2015.
Article
ي En
| WPRIM
| ID: wpr-67434
المكتبة المسؤولة:
WPRO
ABSTRACT
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(R) (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(R) 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.
Key words
النص الكامل:
1
الفهرس:
WPRIM
الموضوع الرئيسي:
Spine
/
Vocal Cords
/
Brain
/
Brain Injuries
/
Intracranial Pressure
/
Laryngoscopes
/
Airway Management
/
Analgesics
/
Intubation
/
Intubation, Intratracheal
المحددات:
Humans
اللغة:
En
مجلة:
Korean Journal of Anesthesiology
السنة:
2015
نوع:
Article