• Martin Glimåker, Bibi Johansson, Halla Halldorsdottir, Michael Wanecek, Adrian Elmi-Terander, and Bo-Michael Bellander.
• Enheten för infektionssjukdomar, medicinska kliniken Solna - Karolinska Institutet och Karolinska Universitetssjukhuset Solna, Stockholm, Sweden Enheten för infektionssjukdomar, medicinska kliniken Solna - Karolinska Institutet och Karolinska Universitetssjukhuset Solna, Stockholm, Sweden.
• Lakartidningen. 2014 Dec 16; 111 (51-52): 2288-91.

AbstractTo evaluate the efficacy of intracranial pressure (ICP)-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM) and severely impaired consciousness, a prospectively designed intervention-control comparison study was performed. Included were patients with confirmed ABM and severely impaired mental status on admission. Fifty-two patients, given ICP-targeted treatment at a neuro-intensive care unit, and 53 control cases, treated with conventional intensive care, were included. All patients received intensive care with me-chanical ventilation, sedation, antibiotics and corticosteroids according to current guidelines. ICP-targeted treatment was performed in the intervention group, aiming at ICP 50 mmHg. The mortality was significantly lower in the intervention group compared to controls, 5/52 (10%) versus 16/53 (30%). Furthermore, only 17 patients (32%) in the control group fully recovered, compared to 28 (54%) in the intervention group. Early neuro-intensive care using ICP-targeted therapy reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission.

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