M Van der Jagt

Prognosis of neurologic complications in critical illness

Neurologic complications of critical illness require extensive clinical and neurophysiologic evaluation to establish a reliable prognosis. Many sequelae of intensive care unit (ICU) treatment, such as delirium and ICU-acquired weakness, although highly associated with adverse outcomes, are less suitable for prognostication, but should rather prompt clinicians to seek previously unnoticed persisting underlying illnesses. Prognostication can be confounded by drug administration particularly because its clearance is abnormal in critical illness. Some neurological complications are severe, and can last for months or years after discharge from ICU. The most important ethical aspects regarding neurologic complications in critically ill patients are prevention, recognition, and identification, and prevention of self-fulfilling prophecies. This chapter summarizes the tool of prognostication of major neurological complications of critical illness.

THE EFFECTS OF INDUCED HYPERTENSION ON CEREBRAL PERFUSION DURING DELAYED CEREBRAL ISCHAEMIA IN ANEURYSMAL SUBARACHNOID HAEMORRHAGE: A RANDOMISED CLINICAL TRIAL

Induced hypertension is often used to treat delayed cerebral ischaemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH) by trying to augment cerebral blood flow (CBF) [1]. However, evidence on effectiveness is lacking, since previous studies on the effect of induced hypertension on CBF are scarce, small and without control groups [2–4].