Management of infections associated with neurocritical care

L Rivera-Lara; W Ziai; P Nyquist

doi:10.1016/B978-0-444-63600-3.00020-9

Management of infections associated with neurocritical care

Handb Clin Neurol. 2017;140:365-378. doi: 10.1016/B978-0-444-63600-3.00020-9.

Authors

L Rivera-Lara¹, W Ziai², P Nyquist³

Affiliations

¹ Department of Anesthesiology and Critical Care Medicine and Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Departments of Anesthesiology and Critical Care Medicine, and Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
³ Departments of Anesthesiology and Critical Care Medicine, Neurology and Neurosurgery, and General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: pnyquis1@jhmi.edu.

PMID: 28187810
DOI: 10.1016/B978-0-444-63600-3.00020-9

Abstract

The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself. Some of these infections may be preventable but many are not. Their appearance do not always constitute a failure of prevention or physician error. Neurointensivists require indepth knowledge of common nosocomial infections, their diagnosis and treatment, and an approach to evidence-based practices that improve processes of care and reduce HAIs.

Keywords: ICU infections; critical care management; neurosurgical care; nosocomial infections; postoperative infection.

Publication types

Review

MeSH terms

Critical Care*
Cross Infection / therapy*
Disease Management
Humans
Intensive Care Units
Neurosurgical Procedures / adverse effects
Postoperative Complications / etiology
Postoperative Complications / therapy