[Therapy of head trauma].
The main target of treatment in patients with head trauma is to maintain the physiological parameters within the following normal limits: intracranial pressure (ICP) below 20 mmHg, cerebral perfusion pressure (CPP) between 50 and 70 mmHg, normoxemia (SpO(2) >90%), normocapnia (paCO(2): 35-38 mmHg), normoglycemia (80-130 mg/dl) and normothermia (36.0-37.5 degrees C). Space-occupying intracranial bleeding or edemas must be evacuated immediately. If these interventions do not result in adequate control of ICP and CPP, the next step would be to administer mannitol and barbiturates. Mild hyperventilation, therapeutic hypothermia, or decompressive craniectomy should be used solely in patients with a persistent ICP increase. Infusion of calcium antagonists or glucocorticoids is never indicated in patients with head trauma.
Engelhard
K
K
Klinik für Anästhesiologie, Johannes Gutenberg-Universität Mainz, Mainz, Germany. engelhak@uni-mainz.de
Müller-Forell
W
W
Werner
C
C
D001463:Barbiturates / Q000627:therapeutic use; D002560:Cerebrovascular Circulation / Q000502:physiology; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D003399:Craniotomy; D019299:Decompression, Surgical; D004632:Emergency Medical Services; D005440:Fluid Therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007036:Hypothermia, Induced; D007427:Intracranial Pressure / Q000502:physiology; D020767:Intracranial Thrombosis / Q000517:prevention & control; D008991:Monitoring, Physiologic
D001463:Barbiturates; D006993:Hypnotics and Sedatives