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Tracheostomy is a routine surgical procedure in patients with severe traumatic brain injury, which requires mechanical ventilation to maintain gas exchange and avoid hypoxemia. Inadequate tracheostomy timing, nursing care, and decannulation would lead to a series of complications, such as aggravated pneumonia and prolonged intubation. The effects of early tracheostomy versus late tracheostomy have been explored. And early tracheostomy is more likely associated with shorter hospital stays and fewer complications. But the relevant reports are controversial. A safe and fast tracheostomy decannulation would facilitate the recovery. However, there was a broad variability in the indications and timing of tracheostomy and decannulation. High-quality evidence is subsequently lacking. We conducted this review to address gaps in knowledge regarding the management strategy and nursing protocol in patients with tracheostomy and decannulation following traumatic brain injury. A multidisciplinary tracheostomy team containing nursing care was also discussed to provide the best service to these patients. [ABSTRACT FROM AUTHOR]

Patients with stroke would have persistent functional deficits despite undergoing physiotherapy and rehabilitation training. Recently, vagus nerve stimulation (VNS), a newly emerging neuroregulatory technique, has been shown to improve motor dysfunction after stroke. Evidence from clinical and preclinical studies has proven the safety, feasibility, and efficacy of invasive and noninvasive VNS. It has been reported that the positive effect may be related to anti-inflammatory effects, mediating neuroplasticity, increasing blood–brain barrier integrity, promoting angiogenesis and reducing spreading depolarization. However, the underlying mechanism remains poorly understood. In this review, we have summarized the potential molecular mechanisms by which VNS promotes stroke prognosis. We believe that VNS combined with upper-extremity rehabilitation can improve impairment and function among moderately to severely impaired stroke survivors. The applications and further exploration are discussed to provide new insights into this novel therapeutic technique. [ABSTRACT FROM AUTHOR]

Tracheostomy is a routine surgical procedure in patients with severe traumatic brain injury, which requires mechanical ventilation to maintain gas exchange and avoid hypoxemia. Inadequate tracheostomy timing, nursing care, and decannulation would lead to a series of complications, such as aggravated pneumonia and prolonged intubation. The effects of early tracheostomy versus late tracheostomy have been explored. And early tracheostomy is more likely associated with shorter hospital stays and fewer complications. But the relevant reports are controversial. A safe and fast tracheostomy decannulation would facilitate the recovery. However, there was a broad variability in the indications and timing of tracheostomy and decannulation. High-quality evidence is subsequently lacking. We conducted this review to address gaps in knowledge regarding the management strategy and nursing protocol in patients with tracheostomy and decannulation following traumatic brain injury. A multidisciplinary tracheostomy team containing nursing care was also discussed to provide the best service to these patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Mao, Zhou, Chen and Zhang.)