Prevention and treatment of homeostatic disorders after central neurosurgical procedures

Prevention and treatment of homeostatic disorders after central neurosurgical procedures requires a coordinated effort by the entire medical team caring for the patient. The goal of management is to optimize physiologic and metabolic variables so that patient outcome is improved. This chapter review...

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Bibliographic Details
Published in:Best practice & research. Clinical anaesthesiology 2007-12, Vol.21 (4), p.539-556
Main Authors: Tolani, Kishore A., MD, Bendo, Audrée A., MD
Format: Article
Language:English
Subjects:
Adrenal Cortex Hormones - adverse effects
Adrenal Cortex Hormones - therapeutic use
Anesthesia & Perioperative Care
Anesthesia, General - adverse effects
anticonvulsants
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Blood Glucose - metabolism
Body Temperature
central neurosurgical procedures
cerebral blood flow
Cerebrovascular Circulation
corticosteroids
Fibrinolytic Agents - therapeutic use
Hemoglobins
Homeostasis
homeostatic disorders
Humans
Neurosurgical Procedures - adverse effects
optimal hemoglobin
optimal serum glucose level
oxygen delivery and consumption
Postoperative Care
Postoperative Complications - etiology
Postoperative Complications - therapy
rewarming and control of shivering
Shivering
temperature management
thrombosis prophylaxis and treatment
Venous Thromboembolism - etiology
Venous Thromboembolism - prevention & control
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Summary:Prevention and treatment of homeostatic disorders after central neurosurgical procedures requires a coordinated effort by the entire medical team caring for the patient. The goal of management is to optimize physiologic and metabolic variables so that patient outcome is improved. This chapter reviews current knowledge and clinical approaches to prevention and treatment of general homeostatic disorders that commonly complicate the postoperative course of neurosurgical patients after general anesthesia. Practice recommendations based on current clinical trials and experience will be made on the following topics: therapeutic approaches to optimal hemoglobin, cerebral blood flow and hemorrheology; prophylaxis and treatment of thrombosis; temperature management including rewarming and the control of shivering; use and side effects of anticonvulsants and corticosteroids; and therapeutic approaches to optimal serum glucose levels.
ISSN:1521-6896
1532-169X
DOI:10.1016/j.bpa.2007.06.004