Respiratory support of the head-injured patient

Approximately 500,000 patients present with a CHI annually in the United States alone. Up to 20% of these injuries are classified as severe. Appropriate and aggressive intensive care of CHI patients will certainly reduce both the morbidity and mortality rates. Early therapy includes provision of adequate ventilation and oxygenation and definitive care based on clinical assessment. Once the acute phase of the injury has passed, supportive therapy should be maintained as long as secondary injury or complications are avoided. Respiratory care of CHI patients is important though different in each phase of the disease. Proper placement of and maintenance of airways, efficient use of and withdrawal from the mechanical ventilator, and providing adequate pulmonary toilet in order to treat or avoid pneumonia are but a few of the very important respiratory care practices necessary to provide optimal outcomes in patients with CHI.