Acute and Critical Care

Review Article

Neurosurgery
Personalized treatment approaches in neurocritical care: Jae Hyun Kim, Chang-Hyun Kim, Hanwool Jeon, Hyun-Chul Jung, Seungjoo Lee; Acute Crit Care. 2026;41(1):33-46. Published online December 8, 2025; DOI: https://doi.org/10.4266/acc.003050

2,009 View
265 Download

Abstract PDF: Acute brain injuries—including traumatic brain injury, subarachnoid hemorrhage, and intracerebral hemorrhage—exhibit profound pathophysiological heterogeneity, yet are often managed using standardized treatment protocols. While evidence-based guidelines have improved outcomes at a population level, they frequently overlook patient-specific variations in cerebral compliance, autoregulation, and metabolic reserve. This review explores the evolving paradigm of personalized neurocritical care, which integrates dynamic multimodal monitoring, individualized intracranial pressure management strategies, and real-time physiological indices such as pressure reactivity index, cerebral perfusion pressure optimization, and waveform analytics. We highlight the role of noninvasive modalities including quantitative pupillometry, transcranial Doppler, optic nerve sheath diameter ultrasound, near-infrared spectroscopy, and electroencephalography as adjuncts when invasive monitoring is limited or contraindicated. Furthermore, we examine tissue-level monitoring using brain oxygen tension and cerebral microdialysis and emerging blood-based biomarkers such as glial fibrillary acidic protein and neurofilament light. These tools provide granular insight into evolving secondary injury processes. In parallel, advances in artificial intelligence (AI) and machine learning enable deep phenotyping, predictive modeling, and integration of high-dimensional data including imaging, physiology, and omics-based profiles. The development of digital twin models further supports individualized simulation and therapeutic planning. While challenges remain in implementation, data harmonization, and resource availability, the convergence of physiologic monitoring, molecular profiling, and computational modeling offers a transformative pathway toward precision medicine in neurocritical care.

Original Articles

Neurosurgery
Deep learning-based model for detection of intracranial waveforms with poor brain compliance in southern Thailand: Thara Tunthanathip, Avika Trakulpanitkit; Acute Crit Care. 2025;40(3):473-481. Published online August 29, 2025; DOI: https://doi.org/10.4266/acc.001425

1,175 View
26 Download
1 Crossref

Background
Intracranial pressure (ICP) waveform analysis provides critical insights into brain compliance and can aid in the early detection of neurological deterioration. Deep learning (DL) has recently emerged as an effective approach for analyzing complex medical signals and imaging data. The aim of the present research was to develop a DL-based model for detecting ICP waveforms indicative of poor brain compliance. Methods: A retrospective cohort study was conducted using ICP wave images collected from postoperative hydrocephalus (HCP) patients who underwent ventriculostomy. The images were categorized into normal and poor compliance waveforms. Precision, recall, mean average precision at the 0.5 intersection over union (mAP_0.5), and the area under the receiver operating characteristic curve (AUC) were used to test. Results: The dataset consisted of 2,744 ICP wave images from 21 HCP patients. The best-performing model achieved a precision of 0.97, a recall of 0.96, and a mAP_0.5 of 0.989. The confusion matrix for poor brain compliance waveform detection using the test dataset also demonstrated a high classification accuracy, with true positive and true negative rates of 48.5% and 47.8%, respectively. Additionally, the model demonstrated high accuracy, achieving a mAP_0.5 of 0.994, sensitivity of 0.956, specificity of 0.970, and an AUC of 0.96 in the detection of poor compliance waveforms. Conclusions: The DL-based model successfully detected pathological ICP waveforms, thereby enhancing clinical decision-making. As DL advances, its significance in neurocritical care will help to pave the way for more individualized and data-driven approaches to brain monitoring and management

Citations

Citations to this article as recorded by

Perioperative Anesthetic Strategies in Emergent Neurosurgery During Severe Traumatic Brain Injury
Denise Baloi, Clayton Rawson, Deondra Montgomery, Michael Karsy, Mehrdad Pahlevani
Trauma Care.2026; 6(1): 5. CrossRef

Neurosurgery
Cost-effectiveness of intracranial pressure monitoring in severe traumatic brain injury in Southern Thailand: Jidapa Jitchanvichai, Thara Tunthanathip; Acute Crit Care. 2025;40(1):69-78. Published online February 21, 2025; DOI: https://doi.org/10.4266/acc.004080

3,762 View
135 Download
3 Web of Science
5 Crossref

Abstract PDF Supplementary Material

Background
Traumatic brain injury (TBI) is a leading cause of fatalities and disabilities in the public health domain, particularly in Thailand. Guidelines for TBI patients advise intracranial pressure monitoring (ICPm) for intensive care. However, information about the cost-effectiveness (CE) of ICPm in cases of severe TBI is lacking. This study assessed the CE of ICPm in severe TBI.
Methods
This was a retrospective cohort economic evaluation study from the perspective of the healthcare system. Direct costs were sourced from electronic medical records, and quality-adjusted life years (QALY) for each individual were computed using multiple linear regression with standardization. Incremental costs, incremental QALY, and the incremental CE ratio (ICER) were estimated, and the bootstrap method with 1,000 iterations was used in uncertainty analysis.
Results
The analysis included 821 individuals, with 4.1% undergoing intraparenchymal ICPm. The average cost of hospitalization was United States dollar ($)8,697.13 (±6,271.26) in both groups. The incremental cost and incremental QALY of the ICPm group compared with the non-ICPm group were $3,322.88 and –0.070, with the base-case ICER of $–47,504.08 per additional QALY. Results demonstrated that 0.007% of bootstrapped ICERs were below the willingness-to-pay (WTP) threshold of Thailand.
Conclusions
ICPm for severe TBI was not cost-effective compared with the WTP threshold of Thailand. Resource allocation for TBI prognosis requires further development of cost-effective treatment guidelines.

Citations

Citations to this article as recorded by

Impact of Preoperative Hair Removal on Self-Esteem after Brain Tumor Surgery
Thara Tunthanathip, Natthanee Pisitthaworakul
Asian Journal of Neurosurgery.2026; 21(01): 147. CrossRef
Deep learning-based model for detection of intracranial waveforms with poor brain compliance in southern Thailand
Thara Tunthanathip, Avika Trakulpanitkit
Acute and Critical Care.2025; 40(3): 473. CrossRef
Feasibility comparison of deep learning image regressions to estimate intracranial pressure from cranial computed tomography in hydrocephalus
Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng
Journal of Neurosciences in Rural Practice.2025; 16: 606. CrossRef
Risk factors and dose-response relationship of catheter-associated urinary tract infection in neurosurgical patients
Thara Tunthanathip, Natthanee Pisitthaworakul
International Journal of Nutrition, Pharmacology, Neurological Diseases.2025; 15(4): 451. CrossRef
Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds
Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng
Journal of Cerebrovascular and Endovascular Neurosurgery.2025; 27(4): 309. CrossRef

Trauma
Bedside ultrasonographic evaluation of optic nerve sheath diameter for monitoring of intracranial pressure in traumatic brain injury patients: a cross sectional study in level II trauma care center in India: Sujit J. Kshirsagar, Anandkumar H. Pande, Sanyogita V. Naik, Alok Yadav, Ruchira M. Sakhala, Sangharsh M. Salve, Aysath Nuhaimah, Priyanka Desai; Acute Crit Care. 2024;39(1):155-161. Published online February 23, 2024; DOI: https://doi.org/10.4266/acc.2023.01172

14,742 View
531 Download
8 Web of Science
8 Crossref

Abstract PDF

Background
Optic nerve sheath diameter (ONSD) is an emerging non-invasive, easily accessible, and possibly useful measurement for evaluating changes in intracranial pressure (ICP). The utilization of bedside ultrasonography (USG) to measure ONSD has garnered increased attention due to its portability, real-time capability, and lack of ionizing radiation. The primary aim of the study was to assess whether bedside USG-guided ONSD measurement can reliably predict increased ICP in traumatic brain injury (TBI) patients.
Methods
A total of 95 patients admitted to the trauma intensive care unit was included in this cross sectional study. Patient brain computed tomography (CT) scans and Glasgow Coma Scale (GCS) scores were assessed at the time of admission. Bedside USG-guided binocular ONSD was measured and the mean ONSD was noted. Microsoft Excel was used for statistical analysis.
Results
Patients with low GCS had higher mean ONSD values (6.4±1.0 mm). A highly significant association was found among the GCS, CT results, and ONSD measurements (P<0.001). Compared to CT scans, the bedside USG ONSD had 86.42% sensitivity and 64.29% specificity for detecting elevated ICP. The positive predictive value of ONSD to identify elevated ICP was 93.33%, and its negative predictive value was 45.00%. ONSD measurement accuracy was 83.16%.
Conclusions
Increased ICP can be accurately predicted by bedside USG measurement of ONSD and can be a valuable adjunctive tool in the management of TBI patients.

Citations

Citations to this article as recorded by

Comparison of the Effects of Conventional and Piezoelectric Osteotomy on Intracranial Pressure Changes in Rhinoplasty Using Ultrasonographic Measurement of Optic Nerve Sheath Diameter
Akif Gunes, Elif Karali, Yusuf Ozgur Bicer, Isa Yildiz, Sıddıka Halicioglu, Nurcan Akbas Gunes
Aesthetic Plastic Surgery.2026;[Epub] CrossRef
Exploring the impact of electroconvulsive therapy on intracranial pressure: A study of optic nerve sheath diameter measurements
Iram Fatima, Aung Khine Phyoe, Abhimanyu Sharma, Shubh Mehta, Sara Tabassum, Manjeet Singh, Rama Siddiqui, Shivendra Shah, Kirpa Kaur, Hend Makky, Aadil Mahmood Khan
The International Journal of Psychiatry in Medicine.2026; 61(1): 39. CrossRef
Personalized treatment approaches in neurocritical care
Jae Hyun Kim, Chang-Hyun Kim, Hanwool Jeon, Hyun-Chul Jung, Seungjoo Lee
Acute and Critical Care.2026; 41(1): 33. CrossRef
Assessment of optic nerve sheath enlargement and Frisen classification in idiopathic intracranial hypertension: Implications for estimating intracranial pressure and grading chronic papilledema
Raghda Shawky El-Gendy, Ahmad Shehata Abd ElHamid, Ayman ElSayed Ali Galhom, Nihal Adel Hassan, Ehab Mahmoud Ghoneim
Taiwan Journal of Ophthalmology.2025; 15(4): 618. CrossRef
Bedside Ultrasonographic Measurement of Optic Nerve Sheath Diameter for Assessing Increased Intracranial Pressure: An Observational Study
Saurav Shekhar, Raj B Singh, Preeti Sharma, Swapna Lata, Nitin Kumar, Ranjeet Rana De, Amit Kumar
Cureus.2025;[Epub] CrossRef
Noninvasive Intracranial Pressure Prediction Using a Multimodal Ultrasound-Based Hemispheric Modeling Strategy: A Prospective Dual-Center Study
Jun Qiu, Tong-Juan Zou, Dong-Mei Wang, Hai-Rong Luo, Hai-Tao Yu, Ling Lei, Wan-Hong Yin
Neurocritical Care.2025; 43(3): 911. CrossRef
Correlation of Optic Nerve Sheath Diameter With Severity and Outcome in Head Injury: Ultrasonographic and CT Evaluation
Syed Ali Mehsam, Sarosh Alam, Zunaira Rizwan , Haris Hanif, Fatima Tariq, Saharish Mansoor Khan
Cureus.2025;[Epub] CrossRef
Measurement of Optic Nerve Sheath Diameter by Bedside Ultrasound in Patients With Traumatic Brain Injury Presenting to Emergency Department: A Review
Preethy Koshy, Charuta Gadkari
Cureus.2024;[Epub] CrossRef

Neurosurgery
Comparison of intracranial pressure prediction in hydrocephalus patients among linear, non-linear, and machine learning regression models in Thailand: Avika Trakulpanitkit, Thara Tunthanathip; Acute Crit Care. 2023;38(3):362-370. Published online August 18, 2023; DOI: https://doi.org/10.4266/acc.2023.00094

4,235 View
75 Download
10 Web of Science
10 Crossref

Abstract PDF

Background
Hydrocephalus (HCP) is one of the most significant concerns in neurosurgical patients because it can cause increased intracranial pressure (ICP), resulting in mortality and morbidity. To date, machine learning (ML) has been helpful in predicting continuous outcomes. The primary objective of the present study was to identify the factors correlated with ICP, while the secondary objective was to compare the predictive performances among linear, non-linear, and ML regression models for ICP prediction.
Methods
A total of 412 patients with various types of HCP who had undergone ventriculostomy was retrospectively included in the present study, and intraoperative ICP was recorded following ventricular catheter insertion. Several clinical factors and imaging parameters were analyzed for the relationship with ICP by linear correlation. The predictive performance of ICP was compared among linear, non-linear, and ML regression models.
Results
Optic nerve sheath diameter (ONSD) had a moderately positive correlation with ICP (r=0.530, P<0.001), while several ventricular indexes were not statistically significant in correlation with ICP. For prediction of ICP, random forest (RF) and extreme gradient boosting (XGBoost) algorithms had low mean absolute error and root mean square error values and high R2 values compared to linear and non-linear regression when the predictive model included ONSD and ventricular indexes.
Conclusions
The XGBoost and RF algorithms are advantageous for predicting preoperative ICP and establishing prognoses for HCP patients. Furthermore, ML-based prediction could be used as a non-invasive method.

Citations

Citations to this article as recorded by

Cost-effectiveness of intracranial pressure monitoring in severe traumatic brain injury in Southern Thailand
Jidapa Jitchanvichai, Thara Tunthanathip
Acute and Critical Care.2025; 40(1): 69. CrossRef
Imaging biomarkers for detection and longitudinal monitoring of ventricular abnormalities from birth to childhood
Antonio Navarro-Ballester, Rosa Álvaro-Ballester, Miguel Á Lara-Martínez
World Journal of Radiology.2025;[Epub] CrossRef
Impact of Preoperative Hair Removal on Self-Esteem after Brain Tumor Surgery
Thara Tunthanathip, Natthanee Pisitthaworakul
Asian Journal of Neurosurgery.2025;[Epub] CrossRef
Deep learning-based model for detection of intracranial waveforms with poor brain compliance in southern Thailand
Thara Tunthanathip, Avika Trakulpanitkit
Acute and Critical Care.2025; 40(3): 473. CrossRef
A nomogram for the prediction of traumatic intracranial abnormalities in the elderly: Development and validation
Apisorn Jongjit, Thara Tunthanathip
Chinese Journal of Traumatology.2025;[Epub] CrossRef
Feasibility comparison of deep learning image regressions to estimate intracranial pressure from cranial computed tomography in hydrocephalus
Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng
Journal of Neurosciences in Rural Practice.2025; 16: 606. CrossRef
Risk factors and dose-response relationship of catheter-associated urinary tract infection in neurosurgical patients
Thara Tunthanathip, Natthanee Pisitthaworakul
International Journal of Nutrition, Pharmacology, Neurological Diseases.2025; 15(4): 451. CrossRef
Prognosis of subarachnoid hemorrhage determined by intracranial pressure thresholds
Thara Tunthanathip, Rakkrit Duangsoithong, Sakchai Sae-Heng
Journal of Cerebrovascular and Endovascular Neurosurgery.2025; 27(4): 309. CrossRef
Assessing interpretability of data‐driven fuzzy models: Application in industrial regression problems
Jorge S. S. Júnior, Carlos Gaspar, Jérôme Mendes, Cristiano Premebida
Expert Systems.2024;[Epub] CrossRef
Progressive Optic Neuropathy in Hydrocephalic Ccdc13 Mutant Mice Caused by Impaired Axoplasmic Transport at the Optic Nerve Head
Mingjuan Wu, Xinyi Zhao, Shanzhen Peng, Xiaoyu Zhang, Jiali Ru, Lijing Xie, Tao Wen, Yingchun Su, Shujuan Xu, Dianlei Guo, Jianmin Hu, Haotian Lin, Tiansen Li, Chunqiao Liu
Investigative Ophthalmology & Visual Science.2024; 65(13): 5. CrossRef

Review Article

Neurosurgery
Target temperature management in traumatic brain injury with a focus on adverse events, recognition, and prevention: Kwang Wook Jo; Acute Crit Care. 2022;37(4):483-490. Published online November 10, 2022; DOI: https://doi.org/10.4266/acc.2022.01291

15,780 View
474 Download
8 Web of Science
9 Crossref

Abstract PDF

Traumatic brain injury (TBI) is a critical cause of disability and death worldwide. Many studies have been conducted aimed at achieving favorable neurologic outcomes by reducing secondary brain injury in TBI patients. However, ground-breaking outcomes are still insufficient so far. Because mild-to-moderate hypothermia (32°C–35°C) has been confirmed to help neurological recovery for recovered patients after circulatory arrest, it has been recognized as a major neuroprotective treatment plan for TBI patients. Thereafter, many clinical studies about the effect of therapeutic hypothermia (TH) on severe TBI have been conducted. However, efficacy and safety have not been demonstrated in many large-scale randomized controlled studies. Rather, some studies have demonstrated an increase in mortality rate due to complications such as pneumonia, so it is not highly recommended for severe TBI patients. Recently, some studies have shown results suggesting TH may help reperfusion/ischemic injury prevention after surgery in the case of mass lesions, such as acute subdural hematoma, and it has also been shown to be effective in intracranial pressure control. In conclusion, TH is still at the center of neuroprotective therapeutic studies regarding TBI. If proper measures can be taken to mitigate the many adverse events that may occur during the course of treatment, more positive efficacy can be confirmed. In this review, we look into adverse events that may occur during the process of the induction, maintenance, and rewarming of targeted temperature management and consider ways to prevent and address them.

Citations

Citations to this article as recorded by

Target temperature management in acute ischemic stroke
Lan Gao, Ting Yang, Hong Chong, Longfei Wu, Jinming Han
Frontiers in Molecular Biosciences.2026;[Epub] CrossRef
Blood pressure variability and functional outcome after decompressive hemicraniectomy in malignant middle cerebral artery infarction
Jae Wook Jung, Ilmo Kang, Jin Park, Sang‐Beom Jeon
European Journal of Neurology.2025;[Epub] CrossRef
State-of-the-art for automated machine learning predicts outcomes in poor-grade aneurysmal subarachnoid hemorrhage using routinely measured laboratory & radiological parameters: coagulation parameters and liver function as key prognosticators
Ali Haider Bangash, Jayro Toledo, Muhammed Amir Essibayi, Neil Haranhalli, Rafael De la Garza Ramos, David J. Altschul, Stavropoula Tjoumakaris, Reza Yassari, Robert M. Starke, Redi Rahmani
Neurosurgical Review.2025;[Epub] CrossRef
Advancements in the application of multimodal monitoring and machine learning for the development of personalized therapeutic strategies in traumatic brain injury
Zhijing Wei, Lingda Meng, Wei Chong
Frontiers in Human Neuroscience.2025;[Epub] CrossRef
Trends and hotspots in research of traumatic brain injury from 2000 to 2022: A bibliometric study
Yan-rui Long, Kai Zhao, Fu-chi Zhang, Yu Li, Jun-wen Wang, Hong-quan Niu, Jin Lei
Neurochemistry International.2024; 172: 105646. CrossRef
Targeted temperature control following traumatic brain injury: ESICM/NACCS best practice consensus recommendations
Andrea Lavinio, Jonathan P. Coles, Chiara Robba, Marcel Aries, Pierre Bouzat, Dara Chean, Shirin Frisvold, Laura Galarza, Raimund Helbok, Jeroen Hermanides, Mathieu van der Jagt, David K. Menon, Geert Meyfroidt, Jean-Francois Payen, Daniele Poole, Frank R
Critical Care.2024;[Epub] CrossRef
A review on targeted temperature management for cardiac arrest and traumatic brain injury
Hiroshi Ito, Sanae Hosomi, Takeshi Nishida, Youhei Nakamura, Jiro Iba, Hiroshi Ogura, Jun Oda
Frontiers in Neuroscience.2024;[Epub] CrossRef
Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction
Jae Wook Jung, Ilmo Kang, Jin Park, Seungjoo Lee, Sang-Beom Jeon
Annals of Intensive Care.2024;[Epub] CrossRef
Severe traumatic brain injury in adults: a review of critical care management
Siobhan McLernon
British Journal of Neuroscience Nursing.2023; 19(6): 206. CrossRef

Original Article

Neurosurgery
The RAP Index during Intracranial Pressure Monitoring as a Clinical Guiding for Surgically Treated Aneurysmal Subarachnoid Hemorrhage: Consecutive Series of Single Surgeon: Sung-Chul Jin, Byung Sam Choi, Jung-Soo Kim; Acute Crit Care. 2019;34(1):71-78. Published online February 28, 2019; DOI: https://doi.org/10.4266/acc.2019.00437

10,524 View
156 Download
5 Web of Science
5 Crossref

Abstract PDF

Background
It is well known that assessing the RAP index along with intracranial pressure (ICP) monitoring in traumatic brain injury patients is helpful. We will discuss the usefulness of this assessment tool as a clinical guide for surgically treated poor grade aneurysmal subarachnoid hemorrhage (SAH).
Methods
This retrospective study included 35 patients with aneurysmal SAH who presented with World Federation of Neurosurgical Societies (WFNS) grade V SAH and received surgical treatment from January 2013 to December 2018. Emergency surgical clipping, hematoma removal, extraventricular drainage, and if needed, wide decompressive craniectomy were combined as the proper surgical treatments. Outcomes were assessed based on in-hospital survival and the Glasgow outcome scale score at 14-day follow-up. We compared the mortality rate of two groups of seven patients: ICP monitoring only (n=5) and ICP monitoring combined with the RAP index (n=2).
Results
The in-hospital 14-day mortality rate by brain lesion was 48.5% (n=17). Seven patients had real-time ICP monitoring. Before 2018, three of five patients with poor WFNS grade who received real-time ICP monitoring only died. There were no deaths in the group of two patients receiving real-time ICP monitoring and the RAP index.
Conclusions
Our data indicate that combining the RAP index and ICP monitoring can be used as markers for critical intracranial physiological parameters in poor grade WFNS patients.

Citations

Citations to this article as recorded by

Exploring Cerebrospinal Compensatory Zones Using a Noninvasive Approach
Sérgio Brasil, Marek Czosnyka, Wellingson S. Paiva, Gustavo Frigieri
Neurocritical Care.2025; 43(3): 834. CrossRef
Continuous monitoring methods of cerebral compliance and compensatory reserve: a scoping review of human literature
Abrar Islam, Logan Froese, Tobias Bergmann, Alwyn Gomez, Amanjyot Singh Sainbhi, Nuray Vakitbilir, Kevin Y Stein, Izabella Marquez, Younis Ibrahim, Frederick A Zeiler
Physiological Measurement.2024; 45(6): 06TR01. CrossRef
Multimodal Neurologic Monitoring in Children With Acute Brain Injury
Jennifer C. Laws, Lori C. Jordan, Lindsay M. Pagano, John C. Wellons, Michael S. Wolf
Pediatric Neurology.2022; 129: 62. CrossRef
Intracranial pressure: current perspectives on physiology and monitoring
Gregory W. J. Hawryluk, Giuseppe Citerio, Peter Hutchinson, Angelos Kolias, Geert Meyfroidt, Chiara Robba, Nino Stocchetti, Randall Chesnut
Intensive Care Medicine.2022; 48(10): 1471. CrossRef
The application value of CT radiomics features in predicting pressure amplitude correlation index in patients with severe traumatic brain injury
Jiaqi Liu, Yingchi Shan, Guoyi Gao
Frontiers in Neurology.2022;[Epub] CrossRef

Case Reports

Propofol-Related Infusion Syndrome in an Adult Patient Using Propofol Coma Therapy to Control Intracranial Pressure: Sang Youn Park, Eu Gene Kim, Hee Pyoung Park; Korean J Crit Care Med. 2013;28(3):234-238.; DOI: https://doi.org/10.4266/kjccm.2013.28.3.234

4,339 View
62 Download
1 Crossref

Abstract PDF

Propofol-related infusion syndrome (PRIS) is a rare but fatal complication. Unexplained metabolic acidosis, rhabdomyolysis, hyperkalemia, myocardial dysfunction, cardiovascular collapse and acute kidney injury are the main characteristics of PRIS. Herein, we report a case of PRIS in a neurosurgical adult patient, who had received high-dose propofol continuous infusion in order to control intracranial pressure in an intensive care unit. She manifested severe metabolic acidosis, rhabdomyolysis, acute kidney injury and myocardial dysfunction. As soon as PRIS was diagnosed, propofol infusion was stopped. Conservative treatments, such as vasopressors and inotropics, continuous renal replacement therapy and extracorporeal membrane oxygenation were used to treat PRIS. However, she finally expired. This case report suggests that a great caution to PRIS is needed in a situation with high-dose propofol continuous infusion.

Citations

Citations to this article as recorded by

Successful treatment of propofol-related infusion syndrome in critically ill patient receiving low-dose propofol infusion: a case report
Nahyeon Park, Tae Sun Ha
Acute and Critical Care.2023; 38(1): 144. CrossRef

Reversal of Focal Neurologic Deficit due to Preoperative Intracranial Pressure Reduction in a Patient with Early Rebleeding of Cerebral Aneurysm: A Case Report: Hyo Seok Na, Sang Hyun Park, Young Tae Jeon, Song Hwan Do, Hwan Hee Kim, Sang Chul Lee, Hee Pyoung Park; Korean J Crit Care Med. 2008;23(1):40-43.; DOI: https://doi.org/10.4266/kjccm.2008.23.1.40

3,303 View
18 Download

Abstract PDF: In the first hours after initial hemorrhage, up to 15% of patients with subarachnoid hemorrhage (SAH) due to aneurysmal rupture may have a sudden episode of clinical deterioration resulting from rebleeding. In patients suffering from an aneurismal rebleeding, the prognosis becomes much poor. Early detection of rebleeding and preoperatively appropriate medical treatment for increased intracranial pressure (IICP) might be crucial to decrease the overall mortality and morbidity rate in a patient with aneurismal rebleeding. We report a case of a successful reversal of focal neurological deficit showed in a patient with abrupt rebleeding of ruptured aneurysm whose intracranial pressure was preoperatively reduced with hyperventilation, and thiopental and mannitol administration under general anesthesia in angiography suite, although the patient ended up in death due to postoperative IICP.

First
Prev
Page of 1
Next
Last

Search