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Chapter 6 - Airway Management and Mechanical Ventilation in the Neurocritical Care Unit

Published online by Cambridge University Press:  24 July 2019

By
David B. Seder  and
Julian Bösel
Edited by
Michel T. Torbey
Michel T. Torbey
Affiliation:
Ohio State University
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Summary

The airway management and mechanical ventilation of patients with neurological disease requires continuous attention to the effects of respiration on neurophysiology. Brain-injured patients frequently lack compensatory reserves and are therefore vulnerable to “minor” physiologic changes to which we may pay little attention – an intubation during which the bed is left flat, ventilation interrupted, light analgosedation administered, and prolonged direct laryngoscopy performed may precipitate brain herniation in a patient with a mass lesion or elevated intracranial pressure (ICP). Yet it takes little effort to minimize the time the head is down, to see that ventilation is not interrupted, and to provide adequate analgosedation – possibly leading to a very different outcome.

Type
Chapter
Information
Neurocritical Care , pp. 50 - 61
Publisher: Cambridge University Press
Print publication year: 2019

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