Retrospective cohort study by Patanwala and colleagues including 233 head injured patients that required RSI with either rocuronium or suxamethonium. The results reveal that sux was associated with increased mortality in the most severely injured subset, compared with roc. In patients with less severe injury there was no significant difference between the two NMBs. Interesting… Continue reading Roc or Sux in RSI of TBI Patients?
Published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine in 2015. “In this systematic review, we did not identify any studies that investigated the supine position and loss of airway patency in trauma patients. However, we found that the supine position was associated with worse airway patency in patients with reduced levels of consciousness in… Continue reading SJTREM – Review Article on Airway Patency in Supine, Unconscious Patients
“Ideal intubation conditions should be obtained through the use of airway manipulation techniques and appropriate medication choice for rapid sequence intubation in patients who are neurologically injured.” Bucher et al, USA. Journal of Emergency Medicine, 2015 Dec. Read the abstract here.
“The evidence of benefit of current strategies remains sparse.” Zwerus et al, The Netherlands. Current Opinions in Anesthesiology, 2015 Aug. Read abstract from the article here.
Nice reading from Pasternak et al. Journal of Neurosurgical Anesthesiology, 2014 Apr. Read the abstract here.
“…PEEP has no significant effect on cerebral and systemic hemodynamics…” Interesting reading about the effects of peep ! Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: the role of respiratory system compliance. Caricato et al, Italy. The Journal of Trauma, 2005 Mar. Abstract available here.
We can use ketamine in patients with traumatic brain injury… The ketamine effect on ICP in traumatic brain injury. Zeiler et al, Canada. Neurocritical Care, 2014 Aug. Access the abstract here.
“Cricoid pressure is contraindicated in patients with suspected cricotracheal injury, active vomiting, or unstable cervical spine injuries.” Cricoid pressure: indications and complications. Landsman, USA. Paediatic Anaesthesia, 2004 Jan. Abstract available here.
The latest version of a Cochrane review of barbiturate therapy for ICP-management. “There is no evidence that barbiturate therapy in patients with acute severe head injury improves outcome. Barbiturate therapy results in a fall in blood pressure in one in four patients. This hypotensive effect will offset any ICP lowering effect on cerebral perfusion pressure”… Continue reading Cochrane Review – Barbiturates for acute traumatic brain injury
Review in Neurocrit Care. 2012. Torre-Healy et al. Hyperosmolar therapy for intracranial hypertension.