Caution during endotracheal suctioning in case of skull base fractures!

Details

Serval ID
serval:BIB_43B04E6D413E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Caution during endotracheal suctioning in case of skull base fractures!
Journal
European review for medical and pharmacological sciences
Author(s)
Lavanchy L., Garvayo M., Abed-Maillard S., Ben-Hamouda N.
ISSN
2284-0729 (Electronic)
ISSN-L
1128-3602
Publication state
Published
Issued date
05/2021
Peer-reviewed
Oui
Volume
25
Number
10
Pages
3803-3806
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Cerebral exteriorization through the cribriform plate during routine endotracheal suctioning (ETS) in a coughing patient without sedation with multiple complex skull base fracture; this case has never been reported in the literature.
We report the case of a polytrauma patient admitted in our ICU with severe traumatic brain injury (TBI) and multiple complex skull base fractures. After 48 hours of neurocritical care and stable neuromonitoring parameters, sedation was stopped for neurological assessment. During this period and while routine ETS was being performed, brain herniation with exteriorization through the nose occurred with a concomitant ICP elevation.
ETS can induce the coughing reflex and provoke a rise in ICP. It is a simple routine procedure that should be performed with great precautions in order to avoid iatrogenic complications, particularly in patients with skull base fractures, such as brain herniation as described in our patient.
Keywords
Brain herniation, skull base fracture, endotracheal suctioning, ICU, polytrauma.
Pubmed
Web of science
Open Access
Yes
Create date
21/05/2021 19:03
Last modification date
29/06/2021 5:35
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