Intensive care management of patients with brain tumours
Essentials of NeuroICU, NOVA Publications , ss.145-167, 2024
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2024
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.145-167
- Anahtar Kelimeler: Brain tumour, Neurointensive care, Peritumoural oedema
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Brain tumours account for 2-3% of malignant neoplasms and approximately 85-90% of primary central nervous system (CNS) tumours. It is responsible for 29.5% of cancerrelated deaths. The neurointensive care follow-up of patients with brain tumours includes the management of medical and neurological complications. Cerebral oedema, seizures, cognitive impairment, depression, dysphagia, and infections in the neurointensive care units due to brain tumour are at risk of venous thromboembolism. Patients with brain tumours may develop neurocognitive impairment due to the disease itself (hydrocephalus, peritumoural oedema, and herniation), surgery, radiotherapy (RT), steroids, and chemotherapy. Routine postoperative treatments for patients with brain tumours include high-dose steroids, H2 blockers, 24-hour antibiotics, pain management, anticonvulsants, and intravenous fluids. Steroids, mannitol, and hypertonic saline may be used in patients with cerebral oedema. Anticoagulation therapy is often used to treat venous thromboemboli in cancer patients but may increase the risk of bleeding complications. Therefore, careful monitoring is necessary to balance the risks and benefits of anticoagulation therapy. Intubation is necessary in patients with a Glasgow Coma Scale below 8 or requiring anaesthesia for intracranial pressure control. Optimal ventilatory management can favourably affect neurological recovery and patient outcomes in intubated patients.