在创伤性脑损伤后,机械通风导致难以奶的患者的实证皮里多斯提格
Tariq Siddiqui1, Gustav Strandvik1,2, Ayman El-Menyar1,3
1Department of Surgery, Trauma Surgery, Hamad Medical Corporation, Doha, Qatar.
European journal of case reports in internal medicine
|April 8, 2024
概括
轻微的创伤性脑损伤可能会引起微妙的泡症状,导致呼吸机依赖. 皮里多斯提格的经验性试验可能有利于疑似肌痛性硬化症 (MG) 难以断奶的患者,即使有负面测试.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
背景情况:
- 轻度创伤性脑损伤 (TBI) 可以呈现出微妙的神经缺陷.
- 患有TBI的患者可能会出现需要机械通风的呼吸衰竭.
- 从机械通风中断奶的困难可能由各种原因引起,包括神经复杂症.
研究的目的:
- 报告一个在轻微的TBI后,机械通风导致难以断奶的病例.
- 为了突出"隐藏"的头骨损伤在引起圆柱体症状中的潜在作用.
- 讨论在依赖呼吸器的患者中疑似肌痛性肌痛症 (MG) 的经验性皮里多斯提格明治疗的实用性.
主要方法:
- 一个30岁的男性轻度TBI的案例报告.
- 临床评估包括神经学检查和头部CT.
- 呼吸机断奶试验和对经验性皮里多斯蒂格治疗的反应.
主要成果:
- 患者在TBI后出现了圆柱状症状 (失声症,脱节症,失症) 和呼吸衰竭.
- 尽管初步康复,但患者未能脱离呼吸机.
- 经验性皮里多斯提格治疗导致成功的断奶,尽管MG的生化测试是负面的.
结论:
- 在TBI之后,细微的泡症状可能表明"隐藏"的头骨损伤.
- 骨髓灰质炎可能与创伤有关,尽管因果关系往往不清楚.
- 在依赖于呼吸机的患者中,经验性皮里多斯蒂格胺试验是有价值的,患者有不明原因的症状,即使MG的诊断测试是负面的.
更多相关视频
09:16Use of a Wireless Video-EEG System to Monitor Epileptiform Discharges Following Lateral Fluid-Percussion Induced Traumatic Brain Injury
Published on: June 21, 2019
25.6K
09:49Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
3.2K
相关概念视频
Depolarizing Blockers: Pharmocokinetics
324
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
324
Skeletal Muscle Relaxants: Therapeutic Uses
482
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
482
Depolarizing Blockers: Mechanism of Action
1.5K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
1.5K
Myasthenia Gravis: Diagnostic Tests
810
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
810
Skeletal Muscle Relaxants: Adverse Effects
363
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
363
