Inventory of a Neurological Intensive Care Unit: Who Is Treated and How Long?

Purpose. To characterize indications, treatment, and length of stay in a stand-alone neurological intensive care unit with focus on comparison between ventilated and nonventilated patient. Methods. We performed a single-center retrospective cohort study of all treated patients in our neurological intensive care unit between October 2006 and December 2008. Results. Overall, 512 patients were treated in the surveyed period, of which 493 could be included in the analysis. Of these, 40.8% had invasive mechanical ventilation and 59.2% had not. Indications in both groups were predominantly cerebrovascular diseases. Length of stay was 16.5 days in mean for ventilated and 3.6 days for nonventilated patient. Conclusion. Most patients, ventilated or not, suffer from vascular diseases with further impairment of other organ systems or systemic complications. Data reflects close relationship and overlap of treatment on nICU with a standardized stroke unit treatment and suggests, regarding increasing therapeutic options, the high impact of acute high-level treatment to reduce consequential complications.

[1]  J. Suarez,et al.  Length of stay and mortality in neurocritically ill patients: Impact of a specialized neurocritical care team* , 2004, Critical care medicine.

[2]  Stefan Schwab,et al.  Hypothermia and Ischemic Stroke , 2012, Current Treatment Options in Neurology.

[3]  T. Gennarelli,et al.  Impact of a neurointensivist on outcomes in patients with head trauma treated in a neurosciences intensive care unit. , 2006, Journal of neurosurgery.

[4]  Su-Hyun Kim,et al.  Clinical Efficacy of Plasmapheresis in Patients with Neuromyelitis Optica Spectrum Disorder and Effects on Circulating Anti-Aquaporin-4 Antibody Levels , 2013, Journal of clinical neurology.

[5]  S. Boy,et al.  Indikationen und Outcome beatmeter Patienten einer neurologischen Intensivstation , 2012, Der Nervenarzt.

[6]  O. Sakowitz,et al.  Standards of Scoring, Monitoring, and Parameter Targeting in German Neurocritical Care Units: A National Survey , 2014, Neurocritical Care.

[7]  K. Einhäupl,et al.  Situation der neurologischen Intensivmedizin in Deutschland Aktuelle Erhebung , 1998, Der Nervenarzt.

[8]  S. Schwab,et al.  Predictors for good functional outcome after neurocritical care , 2010, Critical care.

[9]  Gregory W Albers,et al.  Time to treatment with intravenous alteplase and outcome in stroke: an updated pooled analysis of ECASS, ATLANTIS, NINDS, and EPITHET trials , 2010, The Lancet.

[10]  P. Hao,et al.  Benefits of Early Tracheotomy: A Meta-analysis Based on 6 Observational Studies , 2013, Respiratory Care.

[11]  A. Combes,et al.  Is tracheostomy associated with better outcomes for patients requiring long-term mechanical ventilation?* , 2007, Critical care medicine.

[12]  M. Mitterberger,et al.  Survival and long-term functional outcome in 1,155 consecutive neurocritical care patients* , 2007, Critical care medicine.

[13]  G. Biessels,et al.  Hyperglycemia in acute ischemic stroke: pathophysiology and clinical management , 2010, Nature Reviews Neurology.

[14]  T. Gennarelli,et al.  The impact of a neurointensivist-led team on a semiclosed neurosciences intensive care unit* , 2004, Critical care medicine.

[15]  H. Ellis.  stroke , 1997, The Lancet.

[16]  A. Messori,et al.  Factors influencing the length of hospitalisation in intensive care units: a prospective observational study , 2004, Pharmacy World and Science.

[17]  Lian-di Li,et al.  Effect of timing of tracheotomy on clinical outcomes: an update meta-analysis including 11 trials. , 2013, Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih.

[18]  Tzu-Ching Wu,et al.  Hypothermia for acute ischaemic stroke , 2013, The Lancet Neurology.

[19]  W. Hacke,et al.  Stroke-Related Early Tracheostomy Versus Prolonged Orotracheal Intubation in Neurocritical Care Trial (SETPOINT): A Randomized Pilot Trial , 2013, Stroke.