Impact of advanced local anesthesia in endotracheal on the plateau wave A & B with severe traumatic brain injuries receiving mechanical ventilation
Abstract：Objective To investigate the impact of advanced local anesthesia on the intracranial pressure ( ICP) and plateau wave Lundberg -A&B and incidence of ventilator associated pneumonia (VAP) in patients with severe traumatic brain injuries ( sTBI) receiving mechanical ventilation. Methods Fifty patients with mechanical ventilation in the neurosurgical ICU were divided into treatment group and control group (n=25).When the ICP was at 20~25 mm Hg before suctioning, the treatment group received local anesthesia in endotracheal with lidocaine ultrasonic aerosol inhalation.The change of ICP before and after suctioning at time of 3, 9, 15 and 21 o'clock within five days, frequency of Lundberg-A&B within five days, and the incidence of VAP within seven days during mechanical ventilation were compared.Results In treatment group, the ICP during suctioning was the more stable and the frequency of Lundberg-A was less than the control group.The incidence of VAP was 29.17%in treatment group and 26.09%in control group.The ICP increased more during the suctioning and the frequency of Lundberg-A was the most, and the incidence of VAP was 26.09% in the control group. When the Lundberg-A occurred, the ICP in treatment group was more lower than the other.Whether sputum suction correlates to the occurrence of B wave has not been confirmed in the present study. Conclusion The modified deep suctioning is proved to be a safer and more effective method for patients with sTBI.
Keywords：Traumatic brain injuryIntracranial pressure(ICP)Plateau waveLidocaineSputumVentilator associated pneumonia(VAP)
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 702-705 )