亚低温治疗（Mild hypothermia therapy）
Indications, contraindications and procedures of brain protective treatment for vere traumatic brain injury
[indications]
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1. primary or condary brain stem injury.
2., hypothalamus and other brain midline structural damage associated with central hyperthermia.
3. vere extensive contusion and laceration of brain, obvious brain edema and no indication of operation.
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张 译4. intracranial hematoma after surgical removal, there are still rious brain edema.
[contraindication]
pierre1. late brain hernia, brain stem function has been completely failure.
october怎么读2., the obrvation period of intracranial hematoma can not exclude the need for surgical treatment.
3. vere combined injuries and shock have not been corrected.
4., the original rious cardiopulmonary dysfunction. [operation steps]
1. tracheotomy with an endotracheal tube inrted into the air sac.
2.ICU monitoring intracranial pressure, central venous pressure, cerebral blood flow velocity, Anal temperature, ECG, blood oxygen saturation and vital signs (including blood pressure, respiration, heart rate, pul, etc.).
3. put the patient naked on the ice blanket and cool the ice in the bilateral neck, armpit and groin area.
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4. intravenous muscle relaxant cockstailytic (400mg, 100mg, adding tracrium chlorpromazine and promethazine 100mg physiological saline 500ml), according to the patient's body temperature, heart rate, blood pressure and muscle tension, adjust the dropping speed. The induction temperature is about 40ml/h, and the mild hypothermia is about 10ml/h.
5. after the patient has automatic breathing, u a respirator to keep breathing.
6. gradually reduce the patient's body temperature to 32~34 degrees of treatment, maintain a smooth, low temperature limit of not less than 30 degrees centigrade.
7. improve respiratory tract management during the period of cooling and prevent complications such as lung infection. Daily blood gluco, blood electrolytes, blood coagulation function and blood gas analysis were examined regularly.
8., the cooling time is generally about 1 weeks, intracranial
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pressure drop to normal and stable, can start rewarming.
buddy是什么意思9., rewarming adopts natural rewarming method, after removing muscle relaxant and ice blanket, the patient's spontaneous breathing recovery, body temperature gradually picked up, and the rewarming rate of 4~6 hours ri, 1 degrees is appropriate.
10. when the patient's temperature is normal and the vital signs are stable, they can be transferred to the general care unit for routine treatment.
Operation procedure of mild hypothermia therapeutic apparatus 1, boot:
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Connect the power cord, turn on the power switch, and display the industrial control pattern and status on the LCD screen. The status display is indicated as follows: the dynamic change of the intermediate line indicates that the compressor is working; the rotation of the right rotation indicates the right water circulation at work; the rotation of the left rotation indicates the left water circulation at work.
2, when the u of cooling function:
(1) the water temperature is t with four stalls. When the water temperature tting button is t, the cycle is t. The four files are: 4 to 10; 10 to 15; 15 to 20; 35 to 40. When the water temperature range is between 4 and 10 degrees centigrade, and the temperature is between 10 and 15 degrees centigrade, and the temperature is between 15 and 20 degrees centigrade,
the cooling water function is indicated.
(2) the body temperature is t with four gears, and when the body temperature tting button is t, the cycle is t. The four files are: 33 to 34; 34 to 35; 35 to 36; 36 to 37.
(3) according to the water temperature control switch "ON/OFF", the LCD screen shows a "open" wo
rd sign, which means that the refrigeration function has been allowed to work. Whether the refrigeration system starts or not depends on the temperature of the refrigerant and the temperature t:
A) when the measured temperature exceeds the t temperature range of liquid limit (if t to 4 to 10 DEG C, is up to 10 DEG C) when the compressor starts, the compressor simulation symbols - line gment of dynamic change, said compressor at work.
B) when the measured temperature is lower than the liquid limit t temperature range (if t to 4 to 10 DEG C, while the lower limit is 4 DEG C) when the compressor is stopped, the compressor simulation symbols - line gment static, compressor stop working.
(4) the body temperature nsor is placed on the patient's armpit, and the body temperature control switch "ON/OFF" is displayed on the LCD screen. It shows a "open" word sign, indicating that the corresponding fluid delivery has been allowed. Whether the pump is started depends on the temperature and the temperature it has been t:
(a) when the measured body temperature exceeds the upper limit of the t temperature range (if the temperature is t at 33 DEG C to 34 DEG C, then the upper limit is 34 DEG C), the water cycle
starts, and the corresponding rotation of the rotation symbol at this time.
(b) when the measured body temperature is lower than the lower limit of the t temperature range (if the temperature is t at 33 DEG C to 34 DEG C, then the lower limit is 33 DEG C), the water cycle stops and the corresponding rotation sign is stationary at this time.
(5) in the cour of u, if you want to stop treatment, you can press the temperature switch "ON/OFF" again, the LCD screen "open" disappeared, the water cycle stopped.
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3, when the u of rewarming function:
(1) the water temperature is t with four stalls. When the water temperature tting button is t, the cycle is t. The four files are: 4 to 10; 10 to 15; 15 to 20; 35 to 40. When the water temperature range is between 35 and 40 degrees centigrade, it indicates the u of rewarming function.
(2) the body temperature is t with four gears, and when the body temperature tting button is t, the cycle is t. The four files are: 33 to 34; 34 to 35; 35 to 36; 36 to 37.
(3) according to the water temperature control switch "ON/OFF", the LCD screen shows a "open" word symbol, which means that the temperature has been allowed to work. Whether the rewarming
