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Therapy for Head Trauma (Fluid Therapy (Hypertonic saline (7% NaCl을 주로 사용,…
Therapy for Head Trauma
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metabolic demand를 줄여주어야
Sedation & Analgesia
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Tx seizure aggressively : BZDs, barbiturates
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Surgery? : 골절 부위가 실질 압박, open wound, hematoma, progressive herniation
Fluid Therapy
perfusion parameters 체크 ← non-hemorrhagic shock, hemorrhagic shock, shock+traumatic brain injury 중 어디에 해당하느냐에 따라 기준 다름.
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Synthetic colloids : 출혈 심화, AKI 유발 → 사용x
Hypertonic saline
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면역 조절 및 항염증 효과 in TBI(traumatic brain injury) → give hypertonic saline to traumatic patient w/ shock & TBI
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Turbo-Starch
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Indications : small volume resuscitation, head trauma, reduced adverse effects of hypertonic saline & colloids
Hypovolemic shock
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If severe pulmonary contusion : small volume colloid, limit crystalloids
If head trauma : hypertonic saline + small volume colloid, limit crystalloids
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*Hartmann's sol, Plasma-Lyte와 같은 수액 사용