脑外伤麻醉。

IF 2.3 3区 医学 Q2 ANESTHESIOLOGY Current Opinion in Anesthesiology Pub Date : 2024-10-01 Epub Date: 2024-07-04 DOI:10.1097/ACO.0000000000001404
Nys Willem Siebers, Luzius A Steiner
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引用次数: 0

摘要

审查目的:创伤性脑损伤 (TBI) 带来了复杂的临床挑战,需要对其病理生理学和当前的管理原则有细致入微的了解,以改善患者的预后。麻醉师在护理中发挥着关键作用,需要随时了解最新证据和趋势,以确保高质量的治疗。脑外伤基金会指南》最近一次更新是在 2016 年,其遵守情况一般,目前的管理大多依赖于专家意见。本文献综述综合了当前的证据,并对麻醉师在 TBI 管理中的作用提出了见解:最近的文献强调了量身定制的麻醉管理原则在治疗创伤性脑损伤中的重要性,重点是在神经外科干预或颅外手术中尽量减少继发性脑损伤。新趋势包括个体化颅内压方法和多模态神经监测,以全面评估脑生理学。摘要:TBI 患者的麻醉需要一种综合方法,以平衡麻醉目标和脑损伤的独特病理生理因素。尽管最近的研究拓展了我们的认识,但在标准化方案和解决患者个体反应差异方面仍存在挑战。坚持既定的管理原则、个性化的方法和持续的研究对改善结果至关重要。
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Anesthesia for traumatic brain injury.

Purpose of review: Traumatic brain injury (TBI) presents complex clinical challenges, requiring a nuanced understanding of its pathophysiology and current management principles to improve patient outcomes. Anesthetists play a critical role in care and need to stay updated with recent evidence and trends to ensure high-quality treatment. The Brain Trauma Foundation Guidelines, last updated in 2016, have shown moderate adherence, and much of the current management relies on expert opinions. This literature review synthesizes the current evidence and provides insights into the role of anesthetists in TBI management.

Recent findings: Recent literature has emphasized the importance of tailored anesthetic management principles in treating TBI, focusing on minimizing secondary brain injury during neurosurgical interventions or extracranial surgery. Emerging trends include individualized intracranial pressure approaches and multimodal neuromonitoring for comprehensive assessment of cerebral physiology.

Summary: Anesthesia for TBI patients requires a comprehensive approach that balances anesthetic goals with the unique pathophysiological factors of brain injury. Despite recent research expanding our understanding, challenges remain in standardizing protocols and addressing individual patient response variability. Adherence to established management principles, personalized approaches, and ongoing research is crucial for improving the outcomes.

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来源期刊
CiteScore
4.90
自引率
8.00%
发文量
207
审稿时长
12 months
期刊介绍: ​​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.
期刊最新文献
Postoperative pain management after abdominal transplantations. An update on the perioperative management of postcraniotomy pain. Anesthesia for traumatic brain injury. Harnessing artificial intelligence for predicting and managing postoperative pain: a narrative literature review. Keeping patients in the dark: perioperative anesthetic considerations for patients receiving 5-aminolevulinic acid for glioma resection.
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