Trachéotomie et traumatisme crânien grave : pour qui ? Pourquoi ? Quand ? Comment ?

Rodet-Belarbi, Isabelle; Hamon, Martin; Ferrapie, A.-L.; Rome, Jeffrey D.; Brunel, Pierre; Mathé, J

doi:10.1016/j.annfar.2005.03.010

Cited by 25 publications

(8 citation statements)

References 11 publications

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“…In the initial period following a severe TBI, 14 -18% patients require temporary tracheostomies to maintain a safe and effective airway (Gordon, 1995& Richard, 2005. Once stable, the process of gradual reducing dependency on the tracheostomy (weaning) is initiated.…”

Section: Introductionmentioning

confidence: 99%

Association between Paroxysmal Sympathetic Hyperactivity and tracheostomy weaning in Traumatic Brain Injury

Ringrose

Brown

Walton

et al. 2018

NRE

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Section: Introductionmentioning

confidence: 99%

Association between Paroxysmal Sympathetic Hyperactivity and tracheostomy weaning in Traumatic Brain Injury

Ringrose

Brown

Walton

et al. 2018

NRE

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“…This maneuver permits the airflow to bypass an eventual superior respiratory tract obstruction, avoiding damage to the larynx and superior respiratory tract, which is linked to a prolonged trans-laryngeal intubation (decubitus), and guarantees a way in the inferior respiratory tract for secretions' suction. 1 2 3 …”

Section: Introductionmentioning

confidence: 99%

“…The incidence of tracheostomy in sABI patients is reported to be from 50% to 70%; which indicates the seriousness of the issue. 2 …”

Section: Introductionmentioning

confidence: 99%

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Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after severe Acquired Brain Injury (sABI)

Perin

Meroni

Rega

et al. 2017

Int Arch Otorhinolaryngol

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Introduction Tracheostomy weaning in patients who suffered a severe acquired brain injury is often a challenge and decannulation failures are not uncommon. Objective Our study objective is to describe the decannulation failure rate in patients undergoing rehabilitation following a severe acquired brain injury (sABI); to describe the factors associated with a successful tube weaning. Methods We conduct a retrospective analysis of charts, consecutively retrieved considering a 3-year window. Variables analyzed were: age, sex, body mass index (BMI), Glasgow Coma Scale (GCS), cause of hospitalization (stroke, trauma, cardiac arrest), date of the pathological event, gap between the index event and the first day of hospitalization, duration of Neurorehabilitation Ward hospitalization, comorbidities, chest morphological alteration, kind of tracheostomy tube used (overall dimension, cap, fenestration), SpO2, presentation and quantification of pulmonary secretion, maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), respiratory frequency and pattern, cardiac frequency, presence of spontaneous cough, cough strength, and blood gas analysis. Results We analyzed 45 tracheostomised sABI patients following stroke, trauma, or cardiac arrest. The weaning success percentage was higher in Head Trauma patients and in patients presenting positive spontaneous cough. Failures seem to be associated with presence of secretions and anoxic brain damage. GCS seemed not related to the decannulation outcome. Conclusions Parameters that could be used as positive predictors of weaning are: mean expiratory pressure, presence of spontaneous cough, and cough strength. Provoked cough and GCS were not predictive of weaning success.

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“…Tracheostomies are done in 10% of the patients with brain injury and in 50-70% of the patients in a coma rated below nine in the Glasgow score. The most frequent late complication of tracheostomy is laryngeal and tracheal stenosis, a condition that affects about 15% of the patients submitted to the procedure 3 . When congenital or acquired stenosis involves the subglottic region, surgical treatment is often required due to the relevant clinical repercussions that may set in as a result of the limitation and even cessation of the patient's ability to breathe and speak.…”

Section: Introductionmentioning

confidence: 99%

Avaliação da resposta inflamatória traqueal ao curativo de celulose bacteriana após escarificação cirúrgica em coelhos

Panerari¹,

Costa²,

Souza

et al. 2008

Rev. Bras. Otorrinolaringol.

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Dentre as causas de insucesso nas cirurgias para a estenose traqueal está a formação de tecidos de cicatrização exuberantes. O uso de curativos para evitar esta reação pode ser de grande valia nestes casos. A celulose bacteriana produzida por acetobacter xylinun pode ser útil nestes casos. Não há estudos na região laringotraqueal. OBJETIVO: Avaliar a resposta tecidual subglótica de coelhos após escarificação e colocação de curativo de celulose, comparando com grupo controle. FORMA DE ESTUDO: Experimental MATERIAL E MÉTODOS: Foram estudados 26 coelhos, submetidos a escarificação da região laringotraqueal e tratados com curativo e comparados com controle. Foram estabelecidos 4 tempos de seguimento. Os seguimentos laringotraqueais foram examinados histologicamente e os resultados foram avaliados estaticamente. RESULTADOS: O grupo de estudo evoluiu com o passar do tempo com resultados estatisticamente semelhantes ao do grupo controle, nos parâmetros Congestão vascular, Exsudato purulento, Inflamação aguda, Integridade do epitélio, Proliferação fibrosa e Reação granulomatosa. CONCLUSÃO: Não foram observadas diferenças entre os grupos controle e de estudo quanto aos parâmetros inflamatórios ou cicatriciais. Não houve sinais inflamatórios relacionados ao uso da membrana de celulose que não tivessem ocorrido devido ao traumatismo cirúrgico.

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Trachéotomie et traumatisme crânien grave : pour qui ? Pourquoi ? Quand ? Comment ?

Cited by 25 publications

References 11 publications

Association between Paroxysmal Sympathetic Hyperactivity and tracheostomy weaning in Traumatic Brain Injury

Association between Paroxysmal Sympathetic Hyperactivity and tracheostomy weaning in Traumatic Brain Injury

Parameters Influencing Tracheostomy Decannulation in Patients Undergoing Rehabilitation after severe Acquired Brain Injury (sABI)

Avaliação da resposta inflamatória traqueal ao curativo de celulose bacteriana após escarificação cirúrgica em coelhos

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