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Báo cáo y học: " Recently published papers: A clinical conundrum, new from old and advances in ventilation'

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Recently published papers: A clinical conundrum, new from old and advances in ventilation? | Critical Care February 2005 Vol 9 No 1 Sadler and Williams Commentary Recently published papers A clinical conundrum new from old and advances in ventilation James Sadler1 and Gareth Williams2 Specialist Registrar in Anaesthesia University Hospitals of Leicester Leicester UK 2Consultant in Anaesthesia and Critical Care University Hospitals of Leicester Leicester UK Corresponding author Gareth Williams gareth.williams@uhl-tr.nhs.uk Published online 13 January 2005 This article is online at http ccforum.com content 9 1 16 2005 BioMed Central Ltd Critical Care 2005 9 16-19 DOI 10.1186 cc3049 Abstract Every day clinical conundrums are all too infrequently addressed in the mainstream literature but in the past few months two reports attempted to tackle the thorny problem of the occult cervical spine injury on the intensive care unit. Are we approaching the death knell for prone ventilation and how much more can we squeeze out of the PROWESS study Also we must of course mention noninvasive ventilation. Keywords cervical spine trauma noninvasive ventilation severe sepsis ventilation Cervical spine injury Clearance of potential cervical spine C-spine injury in the awake and cooperative patient with no distracting injury is a standardized procedure. The process becomes more problematic in the unconscious patient leading to delay in C-spine collar removal and consequent complications such as tissue necrosis raised intracranial pressure excessive sedation and so on. Two recent reports addressed this issue 1 2 . In the first of these 1 a postal questionnaire was sent to 32 neurosurgery and spinal injury departments in the UK with the aim of determining how they assessed the C-spine in unconscious adult trauma patients and at what point immobilization was discontinued. The response rate was 84 n 27 . The results demonstrated little consistency between units. The majority of the units questioned had no formal protocol for either screening investigations or criteria for .