• Medicina intensiva · Nov 2019

    Optimization of the neurosurgical patient in Intensive Care.

    • M Santafé Colomina, F Arikan Abelló, A Sánchez Corral, and Ferrer Roca R R Servicio de Medicina Intensiva, Hospital Vall d'Hebron, Barcelona, España..
    • Servicio de Medicina Intensiva, Hospital Vall d'Hebron, Barcelona, España. Electronic address: santafe.manel@gmail.com.
    • Med Intensiva. 2019 Nov 1; 43 (8): 489-496.

    AbstractNeurosurgical patients frequently require admission to intensive care units, either for postoperative management or for treating complications. Most neurosurgical diseases require specific monitoring and prophylaxis. The basic principle of neurosurgical patient management is to ensure correct brain tissue perfusion, i.e., maintaining a sufficient blood flow to supply energy and oxygen to the brain parenchyma. In the last few years, several systems have been developed and improved for monitoring variables such as intracranial pressure, cerebral electrical activity (electroencephalography), cerebral blood flow, parenchymal oxygenation (tissue oxygen pressure) or locoregional metabolism (microdialysis). The present study provides an overview of the general management of neurosurgical patients and the main complications that may occur during the postoperative period. An interventional algorithm is also proposed to facilitate physician decisions, with the inclusion of multimodal neuromonitoring.Copyright © 2019 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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