Postoperative care of the neurosurgical patient

作者：Siegemund Martin; Steiner Luzius A^*

来源：Current Opinion in Anaesthesiology, 2015, 28(5): 487-493.

DOI：10.1097/ACO.0000000000000229

• elective intradural operation
• hyperoxia
• multimodal monitoring
• subarachnoidal hemorrhage
• traumatic brain injury

Purpose of review
Monitoring and therapy of patients in neurocritical care are areas of intensive research and the current evidence needs further confirmation.
Recent findings
A consensus statement of the Neurocritical Care Society and the European Society of Intensive Care Medicine provided pragmatic guidance and recommendations for multimodal monitoring in neurocritical care patients. Only a minority of these recommendations have strong evidence. In addition, recent multicenter randomized controlled trials concerning the therapy of subarachnoidal hemorrhage and traumatic brain injury could not show decreased mortality or improved functional neurologic outcome after the interventions. The current evidence for monitoring and medical therapy in patients after traumatic brain injury and aneurysmal subarachnoid hemorrhage is highlighted in this review.
Summary
Although strong evidence is lacking, multimodal monitoring is of great value in neurocritical care patients and may help to provide patients with the optimal therapy based on the individual pathophysiological changes.

• 出版日期2015-10