Postoperative care of the neurosurgical patient.
OBJECTIVE
Monitoring and therapy of patients in neurocritical care are areas of intensive research and the current evidence needs further confirmation.


RESULTS
A consensus statement of the Neurocritical Care Society and the European Society of Intensive Care Medicine provided pragmatic guidance and recommendations for multimodal monitoring in neurocritical care patients. Only a minority of these recommendations have strong evidence. In addition, recent multicenter randomized controlled trials concerning the therapy of subarachnoidal hemorrhage and traumatic brain injury could not show decreased mortality or improved functional neurologic outcome after the interventions. The current evidence for monitoring and medical therapy in patients after traumatic brain injury and aneurysmal subarachnoid hemorrhage is highlighted in this review.


CONCLUSIONS
Although strong evidence is lacking, multimodal monitoring is of great value in neurocritical care patients and may help to provide patients with the optimal therapy based on the individual pathophysiological changes.
Department for Anesthesia, Surgical Intensive Care, Prehospital Emergency Medicine and Pain Therapy, University Hospital Basel Spitalstrasse 21, Basel 4031, Switzerland.
Martin
M
Siegemund
Luzius A
LA
Steiner
D003422:Critical Care; D017408:Guidelines as Topic; D006801:Humans; D008991:Monitoring, Physiologic; D019635:Neurosurgical Procedures / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*