TAILIEUCHUNG - The stroke patient and methods of critical care: Part 2

(BQ) Continued part 1, part 2 of the document The stroke patient and methods of critical care has contents: Respiratory care of the ICH patient, nutrition in the ICH patient, intraventricular hemorrhage, interventions for cerebellar hemorrhage, craniotomy for treatment of aneurysms,. and other contents. Invite you to refer. | Cambridge Books Online http Critical Care of the Stroke Patient Edited by Stefan Schwab Daniel Hanley A. David Mendelow Book DOI http CBO9780511659096 Online ISBN 9780511659096 Hardback ISBN 9780521762564 Chapter 21b - Respiratory care of the ICH patient pp. 286-296 Chapter DOI http Cambridge University Press 21b Respiratory care of the ICH patient Omar Ayoub and Jeanne Teitelbaum Introduction Indications for intubation and ventilation The overall incidence of intracerebral hemorrhage ICH is estimated to be 12-15 cases per 100000 population 1 . ICH represents around 15-30 of the overall stroke admissions to the hospital and results in significant disability morbidity and 30-50 mortality 2 . The most common cause of death in patients admitted with ICH was found to be withdrawal of lifesustaining interventions and this accounted for 68 of the overall mortality. Indeed the frequency of use of do not resuscitate orders is highly associated with the odds of dying in hospital from ICH 3 . When aggressive management is instituted patients who are treated in the neurologic intensive care unit have a lower mortality rate than those hospitalized in a general ICU 4 . The effect on morbidity however is related to the cause of respiratory failure. When the problem is that of incomplete airway protection due to structural weakness or dysfunction the intubation and ventilation will improve both morbidity and mortality when intubation and ventilation are instituted because of a low GCS the aggressive approach to ventilation will not change overall outcome 5 . This chapter will address airway assessment and management in the critically ill patient with ICH focusing on methods of assessment indications for intubation ventilation and tracheostomy methods of ventilation and the indications and implementation of successful weaning from the ventilator. Among patients admitted to ICUs 20 will have an acute .

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