NCS — Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients
Neurocritical Care Society, 2020
Choose hyperosmolar therapy according to the underlying neurologic condition and physiology. For SAH, symptom-based hypertonic-sodium boluses are preferred over routine sodium-target dosing; there is insufficient evidence for a universal continuous-infusion sodium target to improve neurologic outcomes.
Clinical Context & Relevant Topics (3)
Disease ReferenceMonro-Kellie doctrine, ICP waveforms (P2>P1, Lundberg A-waves), CPP targets (60–70 mmHg), herniation syndromes, and the 4-tier BTF management protocol.
CT-before-LP criteria, CSF interpretation matrix, de Gans Dexamethasone timing, empiric age/host antimicrobial coverage + Ampicillin + Acyclovir, and neurocritical ICP management.
Severe TBI neurocritical care: prevent hypoxemia/hypotension, treat intracranial hypertension, individualize ventilation/CPP, use evidence-based short antiseizure prophylaxis when chosen, and escalate surgery when indicated.