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Non-pharmacological neuroprotection in the ICU 

Non-pharmacological neuroprotection in the ICU
Chapter:
Non-pharmacological neuroprotection in the ICU
Author(s):

Niklas Nielsen

and David B. Seder

DOI:
10.1093/med/9780199600830.003.0230
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date: 25 February 2020

After control of the primary process causing acute neurological injury, further control of secondary injury pathways can be achieved by manipulating brain temperature, and achieving biochemical and metabolic homeostasis. Surgical techniques are routinely used to remove blood or trapped cerebrospinal fluid, control mass effect, or repair unstable vascular abnormalities. Therapeutic temperature management to a defined target can be achieved and maintained using cold fluids, ice packs, body surface cooling pads, and surface and intravascular devices with servo (feedback) mechanisms. Successful temperature management requires attentive surveillance and control of shivering and other potential complications, such as bleeding, infection, cardiac arrhythmias, and electrolyte and metabolic disturbances. Extremes of oxygenation and ventilation are associated with worse long-term functional outcomes, and should be avoided.

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