General Treatment of Stroke in Intensive Care Setting

A. M. Alkhachroum, M. De Georgia

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Meticulous critical care is key to achieve the best possible outcome after stroke. This includes both general critical care and neurocritical care. General critical care focuses on hemodynamics and respiratory care to ensure optimal cerebral blood flow and oxygen delivery in addition to providing adequate nutritional support and prevention of complications such as fever, hyperglycemia, deep venous thrombosis (DVT), stress ulcers, and decubitus pressure ulcers. Neurocritical care focuses on the management of cerebral edema and increased intracranial pressure (ICP). Current guidelines recommend maintaining an ICP < 20. mm. Hg and a cerebral perfusion pressure (CPP) between 50 and 70. mm. Hg. Decompressive craniectomy has been shown to significantly reduce the mortality and improve the functional outcome in patients with malignant hemispheric strokes. Clinicians are cautioned about the early use of do-not-attempt-resuscitation orders, as studies have shown them to be independent predictors of outcome possibly because such orders may lead to less aggressive care and the creation of a self-fulfilling prophecy.

Original languageEnglish (US)
Title of host publicationPrimer on Cerebrovascular Diseases
Subtitle of host publicationSecond Edition
PublisherElsevier Inc.
Pages724-728
Number of pages5
ISBN (Print)9780128030585
DOIs
StatePublished - Mar 7 2017
Externally publishedYes

Keywords

  • Blood pressure
  • Critical care
  • Deep venous thrombosis
  • Fever
  • Hyperglycemia
  • Intracerebral hemorrhage
  • Intracranial pressure
  • Ischemic stroke
  • Seizures

ASJC Scopus subject areas

  • Neuroscience(all)

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