Journal Article

Reducing Intracranial Pressure May Increase Survival among Patients with Bacterial Meningitis

Peter Lindvall, Clas Ahlm, Mats Ericsson, Leif Gothefors, Silvana Naredi and Lars-Owe D. Koskinen

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 3, pages 384-390
Published in print February 2004 | ISSN: 1058-4838
Published online February 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/380970
Reducing Intracranial Pressure May Increase Survival among Patients with Bacterial Meningitis

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We reported findings concerning continuous intracranial pressure (ICP) and cerebral perfusion pressure (CPP) measurements and mortality in patients with severe bacterial meningitis treated on the basis of an ICP-targeted approach. Eighteen patients with severe bacterial meningitis were admitted for neurointensive care at Umeå University Hospital (Umeå, Sweden). In 15 patients, ICP was measured continuously through an ICP measuring device. During care, all patients but one developed intracranial hypertension with an ICP of ⩾15 mm Hg (14 [93%] of 15 patients). Ten (67%) of 15 patients survived and were discharged, and 5 patients (33%) died. Mean ICP was significantly higher and CPP was markedly decreased in nonsurvivors, compared with survivors. Among the survivors, ICP was gradually reduced. Treatment of patients with severe bacterial meningitis should include neurointensive care and continuous ICP measurement. Increased ICP may be reduced by using the ICP-targeted therapy that closely resembles the “Lund concept.”

Journal Article.  3744 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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