Zusammenfassung
Neurochirurgische/-traumatologische Intensivpatienten bilden eine sehr heterogene Gruppe, die sich einerseits aus Patienten nach elektiven neurochirurgischen Eingriffen und andererseits aus Notfallpatienten zusammensetzt (mit und ohne operative Versorgung, in der prä- oder postoperativen Behandlungsphase). Allen Patienten gemeinsam ist die kritische Situation des ZNS mit seinen physiologischen und pathophysiologischen Reaktionen. Primäres Ziel der intensivmedizinischen Behandlung ist die Minimalisierung des sekundären Hirnschadens. Hierfür ist der Erhalt der Homöostase erforderlich, und damit die Prävention ihrer Entgleisung. Abhängig von den Versorgungsstrukturen des betreffenden Krankenhauses wird „neurochirurgische Intensivmedizin“ auf (inter)disziplinär unterschiedlich geführten Stationen betrieben. Alle im Rahmen der intensivmedizinischen Versorgung Tätigen sollten über grundlegende Kenntnisse zu Krankheitsbildern und Basistherapie verfügen. Dies beinhaltet vor allem das Wissen zu Themen wie zentralnervöse Regulationsmechanismen und deren Störungen, Ansätze zur Optimierung zerebraler Perfusion, zentralnervöse Wirkungen von Medikamenten (vor allem Sedativa und Anästhetika), eingriffsspezifische Besonderheiten mit Relevanz für die postoperative Überwachung sowie neurologische Beurteilung (inklusive Diagnostik des irreversiblen Hirnfunktionsausfalls).
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Pilge, S., Schneider, G. (2023). Intensivtherapie nach neurochirurgischen Eingriffen: elektive Kraniotomie, intrakranielle Blutung, Schädel-Hirn-Trauma, Rückenmarkverletzung. In: Marx, G., Muhl, E., Zacharowski, K., Zeuzem, S. (eds) Die Intensivmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54675-4_95-2
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Intensivtherapie nach neurochirurgischen Eingriffen: elektive Kraniotomie, intrakranielle Blutung, Schädel-Hirn-Trauma, Rückenmarkverletzung- Published:
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Intensivtherapie nach neurochirurgischen Eingriffen: elektive Kraniotomie, intrakranielle Blutung, Schädel-Hirn-Trauma, Rückenmarkverletzung- Published:
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DOI: https://doi.org/10.1007/978-3-642-54675-4_95-1