AI Article Synopsis
- Neurosurgical patients often need mechanical ventilation and monitoring in specialized units, but there's limited research on how to safely wean them off these supports.
- Patients who cannot be weaned may require a tracheostomy, though the best timing for this procedure is unclear due to the diverse conditions of critically ill patients.
- The article reviews guidelines for assessing "readiness for extubation" based on neurological and respiratory factors, highlighting the need for more research on predictors of extubation success and optimal tracheostomy timing.
Article Abstract
Neurosurgical patients commonly require mechanical ventilation and monitoring in a neurocritical care unit. There are only few studies that specifically address the process of liberation from mechanical ventilation in this population. Patients who remain ventilator or artificial airway dependent receive a tracheostomy. The appropriate timing for the procedure is not well defined and may be different among an inhomogeneous population of critically ill patients. In this article, we review the general principles of liberation and the current literature as it pertains to neurosurgical patients with primary brain injury. The criteria for "readiness of extubation" include a combination of neurologic assessment, hemodynamic, and respiratory parameters. Future studies are required to better assess indicators for extubation readiness, evaluate the predictors of extubation failure in brain-injured patients, and define the most appropriate timing for a tracheostomy.
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| http://dx.doi.org/10.1016/j.jcrc.2011.08.018 | DOI Listing |
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