Neurocritical Care for Patients With Ischemic Stroke.

Q1 Medicine CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI:10.1212/CON.0000000000001427

T M Leslie-Mazwi

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Abstract

Objective: Management of stroke due to large vessel occlusion (LVO) has undergone unprecedented change in the past decade. Effective treatment with thrombectomy has galvanized the field and led to advancements in all aspects of care. This article provides a comprehensive examination of neurologic intensive care unit (ICU) management of patients with stroke due to LVO. The role of the neurocritical care team in stroke systems of care and the importance of prompt diagnosis, initiation of treatment, and continued monitoring of patients with stroke due to LVO is highlighted.

Latest developments: The management of complications commonly associated with stroke due to LVO, including malignant cerebral edema and respiratory failure, are addressed, stressing the importance of early identification and aggressive treatment in mitigating negative effects on patients' prognoses. In the realm of medical management, this article discusses various medical therapies, including antithrombotic therapy, blood pressure management, and glucose control, outlining evidence-based strategies for optimizing patient outcomes. It further emphasizes the importance of a multidisciplinary approach to provide a comprehensive care model. Lastly, the critical aspect of family communication and prognostication in the neurologic ICU is addressed.

Essential points: This article emphasizes the multidimensional aspects of neurocritical care in treating patients with stroke due to LVO.

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缺血性中风患者的神经重症监护。

目的：在过去十年中，大血管闭塞（LVO）导致的中风治疗经历了前所未有的变化。血栓切除术的有效治疗推动了这一领域的发展，并带动了各方面护理的进步。本文全面探讨了神经重症监护病房（ICU）对 LVO 引起的卒中患者的管理。文章强调了神经重症监护团队在卒中护理系统中的作用，以及对 LVO 引起的卒中患者进行及时诊断、开始治疗和持续监测的重要性：最新进展：论述了 LVO 引起的卒中常见并发症的处理，包括恶性脑水肿和呼吸衰竭，强调了早期识别和积极治疗对减轻患者预后负面影响的重要性。在医疗管理方面，本文讨论了各种医疗疗法，包括抗血栓治疗、血压管理和血糖控制，概述了优化患者预后的循证策略。文章进一步强调了采用多学科方法提供全面护理模式的重要性。最后，还讨论了神经重症监护病房中家属沟通和预后的关键问题：本文强调了神经重症监护在治疗左心室积液引起的卒中患者时的多维性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CONTINUUM Lifelong Learning in Neurology Medicine-Medicine (all)

CiteScore

5.80

自引率

0.00%

发文量

175

期刊介绍： Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.

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