Critical care of the head and neck patient

Objective To report intensive care unit admission outcomes for head and neck cancer patients. Methods A retrospective, observational cohort analysis of all Australian and New Zealander head and neck cancer patient intensive care unit admissions from January 2000 to June 2016, including data from 192 intensive care units. Results There were 10 721 head and neck cancer patients, with a median age of 64 years (71.6 per cent male). Of admissions, 76.4 per cent were in public hospitals, 96.9 per cent were post-operative and 43.6 per cent required mechanical ventilation. Annual head and neck cancer admissions increased from 2000 to 2015 (from 348 to 1132 patients), but the overall proportion of intensive care unit admissions remained constant. In-hospital mortality was 2.7 per cent, and intensive care unit mortality was 0.7 per cent. The in-hospital mortality risk decreased three-fold (p < 0.001). Conclusion Head and neck cancer patients had low mortality in the intensive care unit and in hospital. Risk of dying decreased despite more intensive care unit admissions. This is the first large-scale cohort study quantifying intensive care unit utilisation by head and neck cancer patients. It informs future work investigating alternatives to the intensive care unit for these patients.

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“…the role of early nutrition optimisation in a typically poorly nourished cohort) may also have contributed to these results. 4,9,17–19…”

Section: Discussionmentioning

confidence: 99%

“…This often requires extensive surgery, and patients commonly have significant medical co-morbidities, which confer high peri-operative risk. 1,8,9 Multidisciplinary treatment is delivered by surgeons, oncologists, peri-operative physicians and allied health professionals. 1,10…”

Section: Introductionmentioning

confidence: 99%

Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016

et al. 2021

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“…DBE helps to remove secretions and relax the patients, and also increases chest wall mobility and promotes surfactant production. As lung compliance improves, alveolar ventilation and oxygenation increase and the work of breathing decreases 12 – 21 . The improvement in gas exchange and the reduction in the RR after DBE were both statistically significant in our study.…”

Section: Discussionmentioning

confidence: 99%

Effect of deep breathing exercises on oxygenation after major head and neck surgery

Genç

İkiz

Günerı

et al. 2008

Otolaryngol.--head neck surg.

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“…Los nervios neumogástricos, laríngeo recurrente, espinal accesorio, hipogloso y frénico pueden ser lesionados secundariamente en las heridas del cuello. 2,3 El nervio vago se origina en la médula oblongada, una parte del tronco encefálico, que está localizado en la parte posterior inferior del cerebro. [2][3][4] Es uno de los nervios más largos del cuerpo, ya que va desde el cerebro hasta el colon.…”

Section: Introductionunclassified

“…2,3 El nervio vago se origina en la médula oblongada, una parte del tronco encefálico, que está localizado en la parte posterior inferior del cerebro. [2][3][4] Es uno de los nervios más largos del cuerpo, ya que va desde el cerebro hasta el colon. Suministra fibras nerviosas a la zona de la garganta, los pulmones, el corazón y los órganos digestivos.…”

Section: Introductionunclassified

Sección total del nervio neumogástrico posterior a trauma penetrante de cuello: descripción de un caso.

Borja

Verdezoto

Pineda³

et al. 2015

Rev. Med. UCSG

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El cuello, cuya área representa aproximadamente el 1 % de la superficie corporal, es una región compleja con múltiples componentes anatómicos, casi todos con importancia vital, que están muy expuestos a diversos tipos de traumatismos como accidentes de tránsito, agresiones, y riesgos deportivos; ante lo cual hay que establecer prioridad de atención médica. Los traumas de cuello pueden ser contusos (o cerrados) causados en su mayoría, por accidentes de tránsito, en los que se deben valorar aspectos como aumento del volumen del cuello, edema o hematomas que pueden progresar y causar disnea, disfagia, enfisema subcutáneo y alteraciones de la voz; este mecanismo ha disminuido con el uso de los cinturones de seguridad. La segunda causa es penetrante o abierta, producida por agresiones con armas corto punzante en la cual el daño es limitado, y en menor medida por armas de fuego con consecuencias destructivas y desgarros secundarios. La actuación definitiva debe incluir realización de una cervicotomía lateral amplia con el fin de identificar las lesiones y proceder a repararlas precozmente, más que mantenerlos en observación. En este artículo se presenta el caso de sección total del nervio neumogástrico en un trauma penetrante de cuello con su manejo respectivo.

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Critical care of the head and neck patient

Cited by 14 publications

References 105 publications

Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016

Outcomes for head and neck cancer patients admitted to intensive care in Australia and New Zealand between 2000 and 2016

Effect of deep breathing exercises on oxygenation after major head and neck surgery

Sección total del nervio neumogástrico posterior a trauma penetrante de cuello: descripción de un caso.

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