Treatment of adult patients with craniocerebral trauma complicated by venitalory failure

Abstract

This article contains the current state of knowledge on modern methods of treating patients with severe cranio-cerebral injuries, hospitalized in intensive care clue to respiratory failure. Severe traumatic brain injury [TBI] can be divided into primary and secondary. Primary brain damage takes place in mechanism of direct injury most often due to an impact. Secondary damage is the result of subsequent disorders of physiological conditions such as ischemia and hypoxia ofthe brain areas covered by the primary injury Treatment of patients with severe cranio-cerebral injuries is focused on maintaining proper ventilation, hemodynamic stability and optimal values of intracranial pressure. Maintaining adequate blood flow through brain vessels is necessary to prevent the development of ischemic changes. Respiratory failure develops in these patients by direct injury to the brain in the form of tachypnea, bradypnoea, shortness of breath, sleep apnea, or secondarily to trauma as pneumonia, acute respiratory distress syndrome (ARDS], or pulmonary edema. Mechanical ventilation in patients with TBI seeks to maintain an oxygen partial pressure in the arterial blood of more than 1 1 kPa and the partial pressure of carbon dioxide in the range of 4.5 to 5.0 kPa. The use of appropriate therapy is to prevent the secondary damage to the brain or reduce complications associated with secondary damage.