Travmatik Subaraknoid Hemoraji Olgusunda Yoğun Bakım Yönetimi
Özet
Mandibulaya künt travmaya sekonder gelişen subaraknoid hemoraji ve bilateral ramus mandibula fraktürü tespit edilen 28 yaşındaki erkek hasta Glaskow Koma Skalası (GKS) 13 olarak genel yoğun bakım ünitesine kabul edildi. Takiplerinde GKS’si 6 ‘ya düşen ve konvülsiyon geçiren hasta acil beyin tomografisi çekilerek ameliyathaneye nakil edildi. Beyin cerrahisi tarafından uygulanan Eksternal ventriküler drenaj (EVD) uygulanması tamamlanarak yoğun bakım ünitesine devredildi.10 günün ardından ekstübe edilen hastanın yoğun bakım sürecinde gelişen EVD menenjiti ve pnömoni tedavileri de tamamlanarak 1 aylık yoğun bakım sürecinin ardından maksillofasiyal cerrahi geçireceği üste merkeze sevk edildi.
Referanslar
Bryson HM, Fulton BR, Faulds D. Propofol. An update of its use in anaesthesia and conscious sedation. Drugs. 1995;50(3): 513-59. doi: 10.2165/00003495-199550030-00008
Blakey SA, Hixson-Wallace JA. Clinical significance of rare and benign side effects: propofol and green urine. Pharmacotherapy. 2000;20(9):1120-2. doi: 10.1592/phco.20.13.1120.35041
Shioya N, Ishibe Y, Shibata S. Green Urine Discoloration due to Propofol Infusion: A Case Report. Case Rep Emerg Med. 2011;242514. doi: 10.1155/2011/242514
Barbara DW, Whalen FX Jr. Propofol induction resulting in green urine discoloration. Anesthesiology. 2012;116(4):924. doi: 10.1097/ALN.0b013e31823a13bc
Adembri C, Venturi L, Pellegrini-Giampietro DE. Neuroprotective effects of propofol in acute cerebral injury. CNS Drug Rev. 2007 ;13(3):333-51. doi: 10.1111/j.1527-3458.2007.00015.x
Hutchens MP, Memtsoudis S, Sadovnikoff N. Propofol for sedation in neuro-intensive care. Neurocrit Care. 2006;4(1):54-62. doi: 10.1385/NCC:4:1:054
UpToDate. Sıddık F. Nonaneurysmal subarachnoid hemorrhage 2024.(01/09/2022 tarihinde https://www.uptodate.com/contents/nonaneurysmal-subarachnoid-hemorrhage?csi=67090cb8-915d-4e50-99f0-957b7a3e2f1a&source=contentShare adresinden ulaşılmıştır.)
UpToDate. Venkatakrishna R. Management of acute moderate and severe traumatic brain injury 2024.(01/09/2024 tarihinde https://www.uptodate.com/contents/management-of-acute-moderate-and-severe-traumatic-brain-injury?csi=d6c9a613-c6ff-42dc-b038-5d1c25921ee7&source=contentShare adresinden ulaşılmıştır.)
Sterns RH, Silver SM. Cerebral salt wasting versus SIADH: what difference? J Am Soc Nephrol. 2008;19(2):194–6. doi:10.1681/ASN. 2007101118
Sherlock M, O’Sullivan E, Agha A. Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients. Postgrad Med J. 2009;85(1002):171–5. doi:10.1136/pgmj.2008.072819
Funk G-C, Lindner G, Druml. Incidence and prognosis of dysnatremias present on ICU admission. Intensive Care Med. 2010;36(2):304–11. doi:10.1007/ s00134-009-1692-0
Kozler E, Maresova A, Pokorny A.Cytotoxic brain edema induced by water intoxication and vasogenic brain edema induced by osmotic BBB disruption lead to distinct pattern of ICP elevation during telemetric monitoring in freely moving rats. Neuro Endocrinol Lett. 2019; 40(6): 249-256
Dunn LT. Raised intracranial pressure. J Neurol Neurosurg Psychiatry. 2002; 7:23-7. doi: 10.1136/jnnp.73.suppl_1.i23
Liu H, Wang W, Cheng F. External Ventricular Drains versus Intraparenchymal Intracranial Pressure Monitors in Traumatic Brain Injury: A Prospective Observational Study. World Neurosurg. 2015 ;83(5):794-800. doi: 10.1016/j.wneu.2014.12.040
Cremer OL, van Dijk GW, van Wensen E. Effect of intracranial pressure monitoring and targeted intensive care on functional outcome after severe head injury. Crit Care Med. 2005;33(10):2207-13. doi: 10.1097/01.ccm.0000181300.99078.b5
Carney N, Totten AM, O'Reilly C. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6-15. doi: 10.1227/NEU.0000000000001432
