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Neurointensive care of patients with severe community-acquired meningitis

M Edberg1, M Furebring, J Sjölin

  • 1Department of Neuroscience, Section of Neurosurgery, University Hospital, Uppsala University, Sweden.

Acta Anaesthesiologica Scandinavica
|May 28, 2011
PubMed
Abstract

Insights

Severe bacterial meningitis requires prompt neurointensive care. Early intracranial pressure monitoring and management improve outcomes for critically ill patients.

Area of Science:

  • Neurology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Neurointensive care for severe community-acquired meningitis is underreported.
  • This study reviews the clinical course, management, and outcomes of bacterial meningitis patients in a neurointensive care setting.

Purpose of the Study:

  • To evaluate the effectiveness of neurointensive care protocols for severe bacterial meningitis.
  • To analyze patient outcomes based on Glasgow Outcome Scale.

Main Methods:

  • Retrospective study of 30 patients over 7 years.
  • Neurointensive care included mild hyperventilation, cerebrospinal fluid (CSF) drainage, thiopental infusion, and decompressive craniectomy.
  • Intracranial pressure (ICP) monitoring was utilized in 28 patients.

Main Results:

  • Streptococcus pneumoniae was the most common pathogen (n=18).
  • Elevated ICP (>20 mmHg) was observed in 7/26 patients.
  • Mortality during neurointensive care was 20% (6/30), with 23% (7/30) dying post-discharge.

Conclusions:

  • Severe meningitis necessitates immediate admission to neurointensive care units.
  • Early ICP monitoring and management are crucial for improving patient outcomes.
  • Adherence to modern neurointensive care principles is recommended.

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