TY - CHAP M1 - Book, Section TI - Percutaneous Tracheostomy A1 - Seder, David B. A1 - Yahwak, Jason A. A2 - Lee, Kiwon PY - 2012 T2 - The NeuroICU Book AB - A 30-year-old man is admitted after an unhelmeted bicycling accident in which he suffered a skull fracture, traumatic subarachnoid and subdural hemorrhages, bifrontal contusions, and diffuse axonal injury. He was intubated without medications in the field, and on presentation, the Glasgow Coma Scale (GCS) score is 4. Computed tomography (CT) scan of the neck does not reveal bony injury to the cervical spine. A fiberoptic intracranial pressure (ICP) device is placed, and ICP, cerebral perfusion pressure (CPP), and brain tissue oxygen tension (Pbto2) are monitored. On hospital day 5, the GCS score is 5, ICP is 18 mm Hg, CPP is 70 mm Hg, and Pbto2 in the right frontal lobe near a contusion is 24 mm Hg. His cardiopulmonary status is stable. A rigid cervical collar is in place, and he is maintained on the controlled mechanical ventilation (CMV) mode at a set rate of 14 × 550 mL (actual respiratory rate [RR] is 21 beaths/min), fraction of inspired oxygen (Fio2) of 0.35, and positive end-expiratory pressure (PEEP) of 5. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/24 UR - neurology.mhmedical.com/content.aspx?aid=1101645279 ER -