Craniocerebral injuries: initial treatment and at resuscitation units
Galán Fernández, A.; Fernández-Quero, L.; Navia, J.
Revista Espanola de Anestesiologia y Reanimacion 47(1): 15-30
2000
ISSN/ISBN: 0034-9356 PMID: 10730087 Document Number: 518904
Head injury is the main cause of death or disability among under-45-year-olds. This review covers the main pathophysiological aspects of head injury as well as initial treatment and management in the intensive care recovery ward. The chief therapeutic aim is to maintain adequate cerebral perfusion pressure rather than to maintain normal levels of intracranial pressure. An important challenge is to avoid development of secondary lesions, and in this context arterial hypotensive events that affect prognosis and the survival of such patients merit special attention. We reject treatment based on indiscriminate use of hyperventilation and mannitol and underline the importance of providing adequate sedation and analgesia while maintaining normal flow and pressure and adequate monitoring of such patients.