title: [Intracranial pressure targeted treatment in acute bacterial meningitis increased survival].
abstract: To 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.
authors.affiliation: 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.
authors.forename: Martin
authors.initials: M
authors.lastname: Glimåker
authors.affiliation: Enheten för infektionssjukdomar, medicinska kliniken Huddinge - Karolinska Institutet och Karolinska Universitetssjukhuset Huddinge Huddinge, Sweden Enheten för infektionssjukdomar, medicinska kliniken Huddinge - Karolinska Institutet och Karolinska Universitetssjukhuset Huddinge Huddinge, Sweden.
authors.forename: Bibi
authors.initials: B
authors.lastname: Johansson
authors.affiliation: Anestesikliniken - Karolinska Universitetssjukhuset Solna Stockholm, Sweden Anestesikliniken - Karolinska Universitetssjukhuset Solna Stockholm, Sweden.
authors.forename: Halla
authors.initials: H
authors.lastname: Halldorsdottir
authors.affiliation: Anestesikliniken - Karolinska Universitetssjukhuset Solna Stockholm, Sweden Anestesikliniken - Karolinska Universitetssjukhuset Solna Stockholm, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Wanecek
authors.affiliation: Klinisk Neurovetenskap, sektionen för Neurokirurgi - Karolinska universitetssjukhuset Solna Stockholm, Sweden Klinisk Neurovetenskap, sektionen för Neurokirurgi, - Karolinska universitetssjukhuset Solna Stockholm, Sweden.
authors.forename: Adrian
authors.initials: A
authors.lastname: Elmi-Terander
authors.affiliation: Klinisk Neurovetenskap - Sektionen för Neurokirurgi, Karolinska universitetssjukhuset Solna Stockholm, Sweden Klinisk Neurovetenskap - Sektionen för Neurokirurgi, Karolinska universitetssjukhuset Solna Stgockholm, Sweden.
authors.forename: Bo-Michael
authors.initials: BM
authors.lastname: Bellander
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002552:Cerebral Ventricles; D004322:Drainage; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D019586:Intracranial Hypertension / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D007427:Intracranial Pressure; D008297:Male; D016920:Meningitis, Bacterial / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000302:isolation & purification; D011446:Prospective Studies; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D015996:Survival Rate; D016896:Treatment Outcome