[Refractory hypoxemia treated early by HFO in a severe traumatic brain injury patient].
A 23-year-old man without previous medical history, was transferred to our surgical intensive care unit for management of a traumatic brain injury (Glasgow Coma Score of 3 on admission). He rapidly presented a refractory hypoxaemia essentially due to posterior alveolar collapse. Severe hypoxaemia and hypercarboxaemia didn't respond to conventional ventilation and complicated the management of the brain injury and the control of intracranial pressure. The introduction of high-frequency oscillatory ventilation permitted a respiratory improvement in 48 hours and a good neurological outcome.
Bellamy
L
L
Pôle anesthésie réanimation Samu, CHU de la Cavale-Blanche, Brest, France. lorennb@yahoo.fr <lorennb@yahoo.fr>
Guéret
G
G
Floch
H
H
Wargnier
J-P
JP
Kailitzis
E
E
Arvieux
C-C
CC
D000063:Accidents, Traffic; D000328:Adult; D001929:Brain Edema / Q000209:etiology; D001930:Brain Injuries / Q000150:complications*; D002245:Carbon Dioxide / Q000097:blood; D003128:Coma / Q000209:etiology; D003131:Combined Modality Therapy; D003288:Contusions / Q000209:etiology; D005780:Gelatin / Q000627:therapeutic use; D006612:High-Frequency Ventilation; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D000860:Hypoxia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D019586:Intracranial Hypertension / Q000517:prevention & control; D008297:Male; D009638:Norepinephrine / Q000627:therapeutic use; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D010952:Plasma Substitutes / Q000627:therapeutic use; D001261:Pulmonary Atelectasis / Q000097:blood / Q000150:complications*; D013386:Succinates / Q000627:therapeutic use
D010952:Plasma Substitutes; D013386:Succinates; D002245:Carbon Dioxide; C060085:succinylated gelatin; D005780:Gelatin; D010100:Oxygen; D009638:Norepinephrine