Anästhesiologisches Management bei Schädel-Hirn-Trauma

Beim Schädel-Hirn-Trauma führt eine äußere Gewalteinwirkung auf den Kopf zu einer Funktionsstörung des Gehirns. Die Schwere dieser Hirnverletzung bestimmt maßgeblich die Prognose der Patienten. Dabei ist das Ausmaß der primären Hirnschädigung durch den Anästhesisten nicht mehr beeinflussbar. Ein optimales anästhesiologisches Management kann aber dazu beitragen, dass Folgeschäden – die sog. sekundäre Hirnschädigung – vermieden oder minimiert werden.

Abstract

Traumatic brain injury (TBI) is the main cause of death in people < 45 years in industrial countries. Minimising secondary injury to the injured brain is the primary goal throughout the entire treatment. Anaesthesiologic procedures aim at the reconstitution of cerebral perfusion and homeostasis. Both TBI itself as well as accompanying injuries show effects on cardiac and pulmonary function. Time management plays a crucial role in ensuring a safe anaesthesiologic environment while minimizing unnecessary procedures. Furthermore, growing medical drug pre-treatment demands for further knowledge e.g., in antagonization of anticoagulation.

Schlüsselwörter

Schädel-Hirn-Traum - Hirndruck - zerebraler Perfusionsdruck - anästhesiologische Behandlung - Gerinnungsmanagement

Keywords

traumatic brain injury - intracranial pressure - cerebral perfusion - anaesthesiological treatment - coagulation management

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