Do patients still require admission to an intensive care unit after elective craniotomy for brain surgery?
| العنوان: | Do patients still require admission to an intensive care unit after elective craniotomy for brain surgery? |
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| المؤلفون: | Ossam Rhondali, Céline Genty, Caroline Halle, Marianne Gardellin, Céline Ollinet, Manuela Oddoux, Joëlle Carcey, Gilles Francony, Bertrand Fauvage, Emmanuel Gay, Jean-Luc Bosson, Jean-François Payen |
| المساهمون: | Pôle Anesthésie Réanimation, CHU Grenoble-Hôpital Michallon, Division de Biostatistiques, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, ANTE-INSERM U836, équipe 5, Neuroimagerie fonctionnelle et perfusion cérébrale, CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon, ANTE-INSERM U836, équipe 7, Nanomédecine et cerveau, Département de neurochirurgie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Dojat, Michel |
| المصدر: | Journal of Neurosurgical Anesthesiology Journal of Neurosurgical Anesthesiology, Lippincott, Williams & Wilkins, 2011, 23 (2), pp.118-23. ⟨10.1097/ANA.0b013e318206d5f8⟩ |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Male, Blood transfusion, health care facilities, manpower, and services, medicine.medical_treatment, Plasma Substitutes, resource, intensive care unit, Neurosurgical Procedures, law.invention, Cohort Studies, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, law, MESH: Risk Factors, Risk Factors, MESH: Postoperative Complications, Odds Ratio, postoperative, MESH: Neurologic Examination, Anesthesia, neurosurgery, MESH: Quality of Health Care, MESH: Surgical Procedures, Elective, MESH: Cohort Studies, Craniotomy, MESH: Aged, Neurologic Examination, MESH: Middle Aged, Brain, MESH: Posture, Middle Aged, Intensive care unit, 3. Good health, Elective Surgical Procedures, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, Neurosurgery, Safety, Elective Surgical Procedure, Cohort study, Adult, medicine.medical_specialty, Critical Care, Posture, MESH: Craniotomy, MESH: Blood Transfusion, MESH: Postoperative Care, MESH: Anesthesia, 03 medical and health sciences, MESH: Brain, medicine, Humans, Blood Transfusion, MESH: Intensive Care, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Aged, Quality of Health Care, Postoperative Care, MESH: Humans, business.industry, MESH: Safety, MESH: Adult, MESH: Neurosurgical Procedures, Odds ratio, Perioperative, MESH: Plasma Substitutes, MESH: Male, MESH: Odds Ratio, Surgery, Anesthesiology and Pain Medicine, Neurology (clinical), business, MESH: Female, 030217 neurology & neurosurgery |
| الوصف: | International audience; BACKGROUND: After elective craniotomy for brain surgery, patients are usually admitted to an intensive care unit (ICU). We sought to identify predictors of postoperative complications to define perioperative conditions that would safely allow ICU bypass. METHODS: This observational cohort study enrolled 358 patients admitted to neuro-ICU after elective intracranial procedures. Postoperative complications were defined as unexpected events occurring within 24 hours of surgery that required imaging or treatment for neurologic deterioration. RESULTS: Fifty-two patients were transferred postoperatively to neuro-ICU with sedation and mechanical ventilation. Of the remaining 306 patients subjected to an attempt to awake and extubate in the operating room, 26 (8%) developed 1 postoperative complication, primarily a new motor deficit, unexpected awakening delay, or subsequent deterioration in consciousness. Four intracerebral hematomas required surgical evacuation and each of these was detected within 2 hours after surgery. Predictors of postoperative complications included failure to extubate the trachea in operating room [odds ratio 61.8; 95% confidence interval (CI) 12.2-312.5], and, to a lesser extent, a duration of surgery of more than 4 hours (odds ratio 3.3; 95% CI 1.4-7.8), and lateral positioning of the patient during the procedure (odds ratio 2.8, 95% CI 1.2-6.4). CONCLUSIONS: Our results encourage prospectively testing the hypothesis that patients with immediate, successful tracheal extubation after elective craniotomy for brain surgery, with a surgical duration of less than 4 hours in a nonlateral position could be monitored safely in the postanesthesia care unit before being discharged to a neurosurgical ward. |
| وصف الملف: | application/pdf |
| تدمد: | 1537-1921 0898-4921 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::07b71e23f5dd78f06a86d53e15b1d13e https://pubmed.ncbi.nlm.nih.gov/21270644 |
| حقوق: | EMBARGO |
| رقم الأكسشن: | edsair.doi.dedup.....07b71e23f5dd78f06a86d53e15b1d13e |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15371921 08984921 |
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