Abstract
This chapter will provide the trauma surgeon with the basic guidelines for the provision of appropriate airway management and ventilatory support of the patient being treated for major trauma with a brief focus on penetrating trauma. The chapter will be divided into the following sections: background, physiology and theory, emergency airway management, early ventilation strategies in the emergency department (ED) and intensive care unit (ICU) airway management, and ventilatory strategies. The chapter will conclude with brief comments regarding liberation from the mechanical ventilator.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Recommended Reading
Amato MB, Meade MO, Slutsky AS et al (2015) Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 372:747–755. doi:10.1056/NEJMsa1410639
Aslakson RA, Bridges JFP (2013) Assessing the impact of palliative care in the intensive care unit through the lens of patient-centered outcomes research. Curr Opin Crit Care 19:504–510. PMID: 23995120
Coppola S, Froio S, Chiumello D (2014) Protective lung ventilation during general anaesthesia: is there any evidence? In: Vincent JL (ed) Annual update in intensive care and emergency medicine, 2014. Springer, Switzerland
Desai NR, Myers L, Simeone F (2012) Comparison of 3 different methods used to measure the rapid shallow breathing index. J Crit Care 27(4):418–424. PMID: 21958982
Gattinoni L, Chiumello D, Carlesso E et al (2004) Bench to bedside review: chest wall elastance in acute lung injury/acute respiratory distress syndrome patients. Crit Care 8(5):3505. PMID:15469597 PMCID: PMC106500
Gattinoni L, Cressoni M, Brazzic L (2014) Fluids in ARDS: from onset through recovery. Curr Opin Crit Care 20:373–377. doi:10.1097/MCC.0000000000000105
Gattinoni L, Pesenti A (2005) The concept of “baby lung”. Intensive Care Med 31(6):776–784
Haut ER, Kalish BT, Efron DT et al (2010) Spine immobilization in penetrating trauma: more harm than good? J Trauma 68(1):115–121. doi:10.1097/TA.0b013e3181c9ee58
Hyperventilation. In: Brain Trauma Foundation (2007) Guidelines for the management of severe traumatic brain injury, 3rd edition. J Neurotrauma 24(Suppl 1):S87–S95
Jackson JC, Girard TD, Gordon SM et al (2010) Long-term cognitive and psychological outcomes in the awakening and breathing controlled trial. Am J Respir Crit Care Med 182:183–191. doi:10.1164/rccm.200903-0442OC
Kovacs G, Law JA (eds) (2011) Airway management in emergencies. 2nd edn. Connecticut, USA: Peoples Publishing House
Lachmann B (1992) Open up the lung and keep the lung open. Intensive Care Med 18:319–322
Lou M, Xue F, Chen L et al (2012) Is high PEEP ventilation strategy safe for acute respiratory distress syndrome after severe traumatic brain injury? Brain Inj 26:887–890. doi:10.3109/02699052.2012.660514
Lowe GL, Ferguson ND (2006) Lung-protective ventilation in neurosurgical patients. Curr Opin Crit Care 12:3–7. PMID 1639477
Meng L, Wang C, Li J, Zhang J (2015) Early vs late tracheostomy in critically ill patients: a systematic review and meta-analysis. Clin Respir J. doi:10.1111/crj.12286
Papazian L, Forel J-M, Gacouin A et al (2010) Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 363:1107–1116. doi:10.1056/NEJMoa1005372
Penuelasa O, Thillec AW, Esteban A (2015) Discontinuation of ventilatory support: new solutions to old dilemmas. Curr Opin Crit Care 21:74–81. doi:10.1097/MCC.0000000000000169
Pipeling MR, Fan E (2010) Therapies for refractory hypoxemia in acute respiratory distress syndrome. JAMA 304(22):2521–2527. doi:10.1001/jama.2010.1752
Richards GA, White H, Hopley M (2001) Rapid reduction in oxygenation index by employment of a recruitment technique in patients with severe ARDS. J Intensive Care Med 16:193–199
Roberts JR, Spadafora M, Cone DC (1995) Proper depth of placement of oral endotracheal tubes in adults prior to radiographic confirmation. Acad Emerg Med 2:20–24
Siddiqui UT, Tahir MZ, Shamim MS, Enam SA (2015) Clinical outcome and cost effectiveness of early tracheostomy in isolated severe head injury patients. Surg Neurol Int 6:65. doi:10.4103/2152-7806.155757
Sutherasan Y, Vargas M, Pelosi P (2014) Protective mechanical ventilation in the non-injured lung: review and meta-analysis. In: Vincent JL (ed) Annual update in intensive care and emergency medicine, 2014. Springer, Switzerland
The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308. doi:10.1056/NEJM200005043421801
Turner DA, Rehder KJ, Bonadonna D et al (2014) Ambulatory ECMO as a bridge to lung transplant in a previously well pediatric patient with ARDS. Pediatrics 134(2):583–585
Wade D, Hardy R, Howell D et al (2013) Identifying clinical and acute psychological risk factors for PTSD after critical care: a systematic review. Minerva Anestesiol 79(8):944–963. PMID 2355861
Weingart SD, Levitan RM (2012) Preoxygenation and prevention of desaturation during emergency airway management. Ann Emerg Med 59:165–175. doi:10.1016/j.annemergmed.2011.10.002
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Richards, G.A., Hardcastle, T.C., Hodgson, R.E. (2017). Ventilation in the Trauma Patient: A Practical Approach. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49859-0_13
Download citation
DOI: https://doi.org/10.1007/978-3-662-49859-0_13
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-662-49857-6
Online ISBN: 978-3-662-49859-0
eBook Packages: MedicineMedicine (R0)