Departments of Neurology & Pediatrics, University of California San Francisco, Box 0663, 521 Parnassus Avenue, C-215, San Francisco, CA, 94143-0663, USA,
Curr Treat Options Neurol. 2011 Dec;13(6):574-89. doi: 10.1007/s11940-011-0144-7.
Neurocritical care is an emerging subspecialty that combines expertise in neurology, critical care medicine, neuroradiology, and neurosurgery. Increasing evidence from the adult literature suggests that specialized neurocritical care can lead to improved outcomes following acute brain injury. Critically ill neonates with neurologic conditions may also benefit from specialized neurocritical care. Adherence to guidelines and managing patients in intensive care nurseries with dedicated, multidisciplinary neurocritical care personnel may optimize outcomes. This goal may be achieved by more quickly recognizing neurologic impairment, preventing secondary brain injury by maintaining basic physiologic functions, and rapidly implementing therapies. Nurseries that care for neonates with suspected acute brain injury should be prepared to adequately support multiorgan involvement, monitor the brain to detect seizures, evaluate for brain injury using MRI, and follow development through school age.
神经重症监护是一个新兴的亚专科,它结合了神经病学、重症监护医学、神经放射学和神经外科学方面的专业知识。越来越多的成人文献证据表明,专门的神经重症监护可以改善急性脑损伤后的预后。患有神经系统疾病的危重新生儿也可能受益于专门的神经重症监护。遵循指南并在重症监护病房中由专门的多学科神经重症监护人员管理患者,可能会优化结果。通过更快地识别神经功能障碍、通过维持基本生理功能来防止继发性脑损伤,以及快速实施治疗,可以实现这一目标。护理疑似急性脑损伤新生儿的病房应准备好充分支持多器官受累,监测大脑以发现癫痫发作,使用 MRI 评估脑损伤,并通过学龄期随访发育情况。