THE EFFECT OF EARLY ENDOTRACHEAL INTUBATION ON THE MORBIDITY AND MORTALITY OF PATIENTS WITH SEVERE HEAD INJURY

Abstract

Closed head injuries are majo1• health problems not onlY in developed countries but also in devcioping countries that is due to not onh• i;J terms of their frequency but also because of the fatalities and handicaps that result in the population they most often a fleet. Closed head trauma results in widespread abnormalities 111 brain anatomy, perfusion, metabolism and function. Primary brain injuries occur due to acceleration, deceleration and shearing forces from direct trauma. Secondary brain injuries may be initiated at the time of injury or at any subsequent time. They may be due to increased intracranial pressure, hypoxia, hypotension, fever, hyperglycaemia, ....eel. Hypoxia in T.B.I may occur as a result of aspiration of gastric contents, chest infection, neurogenic, pulmonary oedema or combination of the above. The importance of early airway control is a central principle of trauma care in hospitals. In head injured patients definitive control of the air­ way usually requires endotracheal intubation. Early endotracheal intubation is desired to improve oxygenation and prevent aspiration. This work aimed to evaluate and study the effect of early endotracheal intubation in head injuried patients to prevent secondary hypoxic brain injury and its effect on morbidaty and mortality in these patients. This study was carried out' in Critical Care Medicine in Alexandria Main University Hospital.