Neurosédation en réanimation

Translated title of the contribution: Sedation in neurointensive care unit

J. F. Payen, G. Francony, C. Canet, F. Coppo, B. Fauvage

Research output: Contribution to journalArticle

Abstract

The objectives for using sedation in neurointensive care unit (neuroICU) are somewhat different from those used for patients without severe brain injuries. One goal is to clinically reassess the neurological function following the initial brain insult in order to define subsequent strategies for diagnosis and treatment. Another goal is to prevent severely injured brain from additional aggravation of cerebral blood perfusion and intracranial pressure. Depending on these situations is the choice of sedatives and analgesics: short-term agents, e.g., remifentanil, if a timely neurological reassessment is required, long-term agents, e.g., midazolam and sufentanil, as part of the treatment for elevated intracranial pressure. In that situation, a multimodal monitoring is needed to overcome the lack of clinical monitoring, including repeated measurements of intracranial pressure, blood flow velocities (transcranial Doppler), cerebral oxygenation (brain tissue oxygen tension), and brain imaging. The ultimate stop of neurosedation can distinguish between no consciousness and an alteration of arousing in brain-injured patients. During this period, an elevation of intracranial pressure is usual, and should not always result in reintroducing the neurosedation.

Translated title of the contributionSedation in neurointensive care unit
Original languageFrench
Pages (from-to)1015-1019
Number of pages5
JournalAnnales francaises d'anesthesie et de reanimation
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2009

Keywords

  • Neurointensive care unit
  • Sedation

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Payen, J. F., Francony, G., Canet, C., Coppo, F., & Fauvage, B. (2009). Neurosédation en réanimation. Annales francaises d'anesthesie et de reanimation, 28(12), 1015-1019. https://doi.org/10.1016/j.annfar.2009.10.003