title: Reducing intracranial pressure may increase survival among patients with bacterial meningitis.
abstract: We reported findings concerning continuous intracranial pressure (ICP) and cerebral perfusion pressure (CPP) measurements and mortality in patients with severe bacterial meningitis treated on the basis of an ICP-targeted approach. Eighteen patients with severe bacterial meningitis were admitted for neurointensive care at Umeå University Hospital (Umeå, Sweden). In 15 patients, ICP was measured continuously through an ICP measuring device. During care, all patients but one developed intracranial hypertension with an ICP of >or=15 mm Hg (14 [93%] of 15 patients). Ten (67%) of 15 patients survived and were discharged, and 5 patients (33%) died. Mean ICP was significantly higher and CPP was markedly decreased in nonsurvivors, compared with survivors. Among the survivors, ICP was gradually reduced. Treatment of patients with severe bacterial meningitis should include neurointensive care and continuous ICP measurement. Increased ICP may be reduced by using the ICP-targeted therapy that closely resembles the "Lund concept."
authors.affiliation: Department of Neurosurgery, Umeå University Hospital, Umeå, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Lindvall
authors.forename: Clas
authors.initials: C
authors.lastname: Ahlm
authors.forename: Mats
authors.initials: M
authors.lastname: Ericsson
authors.forename: Leif
authors.initials: L
authors.lastname: Gothefors
authors.forename: Silvana
authors.initials: S
authors.lastname: Naredi
authors.forename: Lars-Owe D
authors.initials: LO
authors.lastname: Koskinen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019586:Intracranial Hypertension / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D007427:Intracranial Pressure; D008297:Male; D016920:Meningitis, Bacterial / Q000401:mortality* / Q000503:physiopathology; D008875:Middle Aged; D016019:Survival Analysis