Current advances in neurocritical care
This review summarizes the current research advances and guideline updates in neurocritical care. For the therapy of ischemic stroke, the extended treatment time window for thrombectomy and the emergence of novel thrombolytic agents and strategies have brought greater hope for patient recovery. Mini...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Intensive Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667100X24000707 |
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| author | Yuqing Chen Shuya Wang Shanshan Xu Ningyuan Xu Linlin Zhang Jianxin Zhou |
| author_facet | Yuqing Chen Shuya Wang Shanshan Xu Ningyuan Xu Linlin Zhang Jianxin Zhou |
| author_sort | Yuqing Chen |
| collection | DOAJ |
| description | This review summarizes the current research advances and guideline updates in neurocritical care. For the therapy of ischemic stroke, the extended treatment time window for thrombectomy and the emergence of novel thrombolytic agents and strategies have brought greater hope for patient recovery. Minimally invasive hematoma evacuation and goal-directed bundled management have shown clinical benefits in treating cerebral hemorrhage. In the treatment of aneurysmal subarachnoid hemorrhage (aSAH), early lumbar drainage can reduce the risk of infarction. Decompressive craniectomy for severe traumatic brain injury has also obtained high-quality evidence support. However, multimodal brain monitoring strategies for patients with traumatic brain injury need further optimization. For patients with cardiac arrest, extracorporeal cardiopulmonary resuscitation can reduce in-hospital mortality and improve long-term neurological prognosis. For neurocritical care patients, abundant high-quality studies have emerged in areas including multimodal neuromonitoring, hemodynamic management, airway management and respiratory therapy, and antiepileptic treatment. In 2023, the guidelines for aSAH have been updated for the first time in the past decade, aiming to provide evidence-based practice recommendations for clinical care. Chinese expert consensuses have also been formulated to guide analgesia and sedation for neurocritical care patients and developed a set of medical quality indicators on neurocritical care, which will enhance standardization and homogenization improvement in neurocritical care quality. |
| format | Article |
| id | doaj-art-465c7284b8af488ba629336660e6d82b |
| institution | Kabale University |
| issn | 2667-100X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Intensive Medicine |
| spelling | doaj-art-465c7284b8af488ba629336660e6d82b2025-01-05T04:28:46ZengElsevierJournal of Intensive Medicine2667-100X2025-01-01512331Current advances in neurocritical careYuqing Chen0Shuya Wang1Shanshan Xu2Ningyuan Xu3Linlin Zhang4Jianxin Zhou5Department of Critical Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Critical Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Corresponding author: Linlin Zhang, Department of Critical Care Unit, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.Department of Critical Care Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing, ChinaThis review summarizes the current research advances and guideline updates in neurocritical care. For the therapy of ischemic stroke, the extended treatment time window for thrombectomy and the emergence of novel thrombolytic agents and strategies have brought greater hope for patient recovery. Minimally invasive hematoma evacuation and goal-directed bundled management have shown clinical benefits in treating cerebral hemorrhage. In the treatment of aneurysmal subarachnoid hemorrhage (aSAH), early lumbar drainage can reduce the risk of infarction. Decompressive craniectomy for severe traumatic brain injury has also obtained high-quality evidence support. However, multimodal brain monitoring strategies for patients with traumatic brain injury need further optimization. For patients with cardiac arrest, extracorporeal cardiopulmonary resuscitation can reduce in-hospital mortality and improve long-term neurological prognosis. For neurocritical care patients, abundant high-quality studies have emerged in areas including multimodal neuromonitoring, hemodynamic management, airway management and respiratory therapy, and antiepileptic treatment. In 2023, the guidelines for aSAH have been updated for the first time in the past decade, aiming to provide evidence-based practice recommendations for clinical care. Chinese expert consensuses have also been formulated to guide analgesia and sedation for neurocritical care patients and developed a set of medical quality indicators on neurocritical care, which will enhance standardization and homogenization improvement in neurocritical care quality.http://www.sciencedirect.com/science/article/pii/S2667100X24000707Neurocritical careIntracerebral hemorrhageTraumatic brain injurySubarachnoid hemorrhageCardiac arrestEndovascular therapy |
| spellingShingle | Yuqing Chen Shuya Wang Shanshan Xu Ningyuan Xu Linlin Zhang Jianxin Zhou Current advances in neurocritical care Journal of Intensive Medicine Neurocritical care Intracerebral hemorrhage Traumatic brain injury Subarachnoid hemorrhage Cardiac arrest Endovascular therapy |
| title | Current advances in neurocritical care |
| title_full | Current advances in neurocritical care |
| title_fullStr | Current advances in neurocritical care |
| title_full_unstemmed | Current advances in neurocritical care |
| title_short | Current advances in neurocritical care |
| title_sort | current advances in neurocritical care |
| topic | Neurocritical care Intracerebral hemorrhage Traumatic brain injury Subarachnoid hemorrhage Cardiac arrest Endovascular therapy |
| url | http://www.sciencedirect.com/science/article/pii/S2667100X24000707 |
| work_keys_str_mv | AT yuqingchen currentadvancesinneurocriticalcare AT shuyawang currentadvancesinneurocriticalcare AT shanshanxu currentadvancesinneurocriticalcare AT ningyuanxu currentadvancesinneurocriticalcare AT linlinzhang currentadvancesinneurocriticalcare AT jianxinzhou currentadvancesinneurocriticalcare |