Travmada Mekanik Ventilasyon İlkeleri
Özet
Travmada mekanik ventilasyon, solunum yetmezliği gelişen travma hastalarında kritik bir müdahale olup beraberinde ventilatör kaynaklı yaralanmaları en aza indirmeyi hedefler. Hipoksemi, hiperkapni, solunum yetersizliği ve bilinç kaybı gibi durumlar mekanik ventilasyon için başlıca endikasyonlardır. Koruyucu ventilasyon stratejileri, ekspirasyon sonu pozitif başınç (positive end-expiratory pressure = PEEP) kullanımı, yelken göğüs (flail chest) ve kafa travması gibi spesifik travma durumlarında uygulanması gereken ventilasyon yaklaşımlarına burada değinilecektir. Uygun ventilasyon parametrelerinin belirlenmesi, bunun yanında komplikasyonların (özellikle barotravma, volütravma ve hemodinamik bozulmalar) yönetimi ve travma hastalarında sağ kalımı artırmak için önemlidir.
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