Neurocritical care update

Abstract

This update comprises six important topics under neurocritical care that require reevaluation. For post-cardiac arrest brain injury, the evaluation of the injury and its corresponding therapy, including temperature modulation, is required. Analgosedation for target temperature management is an essential strategy to prevent shivering and minimizes endogenous stress induced by catecholamine surges. For severe traumatic brain injury, the diverse effects of therapeutic hypothermia depend on the complicated pathophysiology of the condition. Continuous electroencephalogram monitoring is an essential tool for detecting nonconvulsive status epilepticus in the intensive care unit (ICU). Neurocritical care, including advanced hemodynamic monitoring, is a fundamental approach for delayed cerebral ischemia following subarachnoid hemorrhage. We must be mindful of the high percentage of ICU patients who may develop sepsis-associated brain dysfunction.

Keywords: Electroencephalogram monitoring; Neurocritical care; Nonconvulsive status epilepticus; Review; Sepsis-associated brain dysfunction; Shivering; Target temperature management.

Fig. 1

Anti-shivering protocol example and the bedside shivering assessment scale. IV intravenous, PT per feeding tube, ECG electrocardiogram. Modified from Brophy [25] and Badjatia [24] with permission