Effect of intravenous midazolam on intracranial pressure during endotracheal suctioning in patients with severe head injury

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Effect of bolus doses of midazolam on intracranial pressure and cerebral perfusion pressure in patients with severe head injury.

We have studied the effects of bolus doses of midazolam 0.15 mg kg-1 i.v. on intracranial pressure (ICP), mean arterial pressure (MAP) and cerebral perfusion pressure (CPP) in 12 patients with severe head injury (Glasgow Coma Scale score < or = 6). The study was performed in patients aged 17-44 yr who were sedated (phenoperidine 20 micrograms kg-1 h-1) and paralysed (vecuronium 2 mg h-1). Midaz...

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Intracranial pressure monitoring in patients with severe head injury.

Increased intracranial pressure (ICP) has an adverse effect on the clinical course of patients with severe head injuries. Direct intracranial measurement is the only method of knowing the precise ICP. At the Maryland Institute for Emergency Medical Services Systems, elevations in ICP are treated according to an aggressive protocol. Our experience with this protocol has led to the following conc...

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Effect of cervical collars on intracranial pressure in patients with head neurotrauma

Trauma patients are at high risk of cervical and associated injuries. The standard protocol includes immobilization of the cervical spine in a polytrauma as it will help to prevent spinal injuries in the prehospital settings. Hard cervical collar (or alternatives) is routinely used until the cervical spine clearance is obtained . In patients with traumatic brain injury avoiding any kind of mane...

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Cerebral perfusion pressure management of severe diffuse head injury: effect on brain compliance and intracranial pressure.

BACKGROUND Cerebral perfusion pressure management (CPPM) is an accepted modality of treatment of severe diffuse head injury (SDHI). However, CPPM has the potential to cause transcapillary exudation in the presence of a disrupted blood brain barrier and can lead to further increase of intracranial pressure (ICP) and worsening of compliance. AIMS This study attempts to evaluate the effect of bo...

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Effect of applying positive pressure with or without endotracheal suctioning during extubation: a laboratory study.

BACKGROUND During invasive mechanical ventilation, secretions accumulate in the subglottic space; consequently, there is a risk of aspiration of these secretions into the airway during cuff deflation and extubation. To minimize this risk, 2 extubation methods are used. The first consists of introducing a suction catheter into the endotracheal tube (ETT) and the trachea. After initiating suction...

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ژورنال

عنوان ژورنال: Journal of Neuroanaesthesiology and Critical Care

سال: 2017

ISSN: 2348-0548

DOI: 10.4103/jnacc.jnacc_78_16