POST-OPERATIVE PROTOCOL FOR BRAIN TUMOR SURGERY IN INTENSIVE CARE UNIT: A LITERATURE REVIEW

Authors

  • Dwi Indriati Kusumawardani Anaesthesiolgy Resident, Departement of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Gadjah Mada University / Gadjah Mada Teaching Hospital, Special Region of Yogyakarta, Indonesia
  • Bowo Adiyanto Division of Intensive Care, Departement of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Gadjah Mada University / Dr. Sardjito Centre General Hospital, Special Region of Yogyakarta, Indonesia

DOI:

https://doi.org/10.61841/vv043b66

Keywords:

Post-operative protocol, brain tumor surgery, intensive care unit

Abstract

Background: Brain tumors represent a diverse group of neoplasms arising from intracranial tissues, posing significant clinical challenges and impacting public health globally. With primary brain tumors having an annual incidence of around 14 per 100,000 individuals and secondary brain tumors being even more prevalent, the burden on healthcare systems is substantial. Postoperative care, particularly in the intensive care unit (ICU), plays a crucial role in monitoring patients for early detection of complications and maintaining neurological and systemic homeostasis.  This study aims to serve a literature review to examine post operative management in brain surgery operation in the ICU in literatures.  

Result and Discussion: Protocols for ICU management post-brain tumor surgery are essential, with factors such as patient status, surgical site, and anticipated postoperative needs guiding decisions regarding ICU admission and monitoring. Neuroprotective strategies encompass physiological and pharmacological interventions aimed at mitigating adverse outcomes, with a multifaceted approach necessary for optimal neuroprotection.

Conclusion: A comprehensive understanding of the surgical and postoperative management of brain tumors along with the implementation of evidence-based protocols for ICU care are essential to improve patient outcomes and minimize complications. Continued advancements in surgical techniques, neuroprotective strategies, and critical care management are crucial in addressing the complex challenges posed by brain tumors and enhancing the quality of care for affected patients.

References

Popugaev KA, Lubnin AY. Postoperative Care in Neurooncology. In: Wartenberg KE, Shukri K, Abdelhak T, editors. Neurointensive Care: A Clinical Guide to Patient Safety. Cham: Springer International Publishing; 2015. p. 95–123. Available from: https://doi.org/10.1007/978-3-319-17293-4_7

Chauhan R, Bloria S, Luthra A. Management of Postoperative Neurosurgical Patients. Indian Journal of Neurosurgery. 2019 Sep 24;08.

Uribe AA, Stoicea N, Echeverria-Villalobos M, Todeschini AB, Esparza Gutierrez A, Folea AR, et al. Postoperative Nausea and Vomiting After Craniotomy: An Evidence-based Review of General Considerations, Risk Factors, and Management. Journal of Neurosurgical Anesthesiology. 2021 Jul;33(3):212.

Errico M, Luoma AMV. Postoperative care of neurosurgical patients: general principles. Anaesthesia & Intensive Care Medicine. 2023 May 1;24(5):282–90.

Dewan MC, Rattani A, Gupta S, Baticulon RE, Hung YC, Punchak M, et al. Estimating the global incidence of traumatic brain injury. J Neurosurg. 2018 Apr 27;130(4):1080–97.

Wan A WZ, Luoma AMV. Postoperative care of neurosurgical patients: general principles. Anaesthesia & Intensive Care Medicine. 2020 Jul 1;21(7):349–55.

Stocchetti N, Carbonara M, Citerio G, Ercole A, Skrifvars MB, Smielewski P, et al. Severe traumatic brain injury: targeted management in the intensive care unit. Lancet Neurol. 2017 Jun;16(6):452–64.

Hanak BW, Walcott BP, Nahed BV, Muzikansky A, Mian MK, Kimberly WT, et al. Postoperative intensive care unit requirements after elective craniotomy. World Neurosurg. 2014 Jan;81(1):165–72.

Beauregard CL, Friedman WA. Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis. Surgical Neurology. 2003 Dec 1;60(6):483–9.

Rhondali O, Genty C, Halle C, Gardellin M, Ollinet C, Oddoux M, et al. Do Patients Still Require Admission to an Intensive Care Unit After Elective Craniotomy for Brain Surgery? Journal of Neurosurgical Anesthesiology. 2011 Apr;23(2):118.

Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GWJ, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017 Jan;80(1):6.

Velly L, Simeone P, Bruder N. Postoperative Care of Neurosurgical Patients. Curr Anesthesiol Rep. 2016 Sep 1;6(3):257–66.

Parney IF, Berger MS. Chapter 15 - Principles of brain tumor surgery. In: Aminoff MJ, Boller F, Swaab DF, editors. Handbook of Clinical Neurology. Elsevier; 2012. p. 187–213. (Neuro-Oncology; vol. 104). Available from: https://www.sciencedirect.com/science/article/pii/B9780444521385000153

McFaline-Figueroa JR, Lee EQ. Brain Tumors. The American Journal of Medicine. 2018 Aug 1;131(8):874–82.

Butowski NA. Epidemiology and Diagnosis of Brain Tumors. CONTINUUM: Lifelong Learning in Neurology. 2015 Apr;21(2):301.

Krajewski S, Furtak J, Zawadka-Kunikowska M, Kachelski M, Birski M, Harat M. Rehabilitation Outcomes for Patients with Motor Deficits after Initial and Repeat Brain Tumor Surgery. International Journal of Environmental Research and Public Health. 2022 Jan;19(17):10871.

Asthagiri AR, Pouratian N, Sherman J, Ahmed G, Shaffrey ME. Advances in Brain Tumor Surgery. Neurologic Clinics. 2007 Nov 1;25(4):975–1003.

Kementerian Kesehatan. Pedoman Nasional Pelayanan Kedokteran (PNPK). 2020. Available from: https://www.kemkes.go.id/id/pnpk-2020---tata-laksana-tumor-otak

Lenga P, Kleineidam H, Unterberg A, Dao Trong P. Optimizing patient outcome in intracranial tumor surgery: a detailed prospective study of adverse events and mortality reduction strategies in neurosurgery. Acta Neurochir. 2024 Mar 8;166(1):126.

Keown T, Bhangu S, Solanki S. Anaesthesia for Craniotomy and Brain Tumour Resection. 2022;

Chen L, Xu M, Li GY, Cai WX, Zhou JX. Incidence, Risk Factors and Consequences of Emergence Agitation in Adult Patients after Elective Craniotomy for Brain Tumor: A Prospective Cohort Study. PLOS ONE. 2014 Dec 10;9(12):e114239.

Azad TD, Shah PP, Kannapadi NV, Rincon-Torroella J, Xia Y, Bernhardt LJ, et al. Reexamining the Role of Postoperative ICU Admission for Patients Undergoing Elective Craniotomy: A Systematic Review*. Critical Care Medicine. 2022 Sep;50(9):1380.

Lonjaret L, Guyonnet M, Berard E, Vironneau M, Peres F, Sacrista S, et al. Postoperative complications after craniotomy for brain tumor surgery. Anaesthesia Critical Care & Pain Medicine. 2017 Aug 1;36(4):213–8.

Badenes R, Prisco L, Maruenda A, Taccone FS. Criteria for Intensive Care admission and monitoring after elective craniotomy. Curr Opin Anaesthesiol. 2017 Oct;30(5):540–5.

Das KC, Rajagopalan V, Rath GP. Critical Care Management in Patients Undergoing Brain Tumor Surgery. In: Kumar V, Gupta N, Mishra S, editors. Onco-critical Care: An Evidence-based Approach. Singapore: Springer Nature; 2022. p. 399–422. Available from: https://doi.org/10.1007/978-981-16-9929-0_34

Narvaez-Rojas A, Mo-Carrascal J, Maraby J, Satyarthee G, Hoz S, Joaquim A, et al. Neurocritical Care of Intracranial Brain Tumor Surgery: An Overview. MAMC J Med Sci. 2018;4(1):4.

Neumann JO, Schmidt S, Nohman A, Jakobs M, Unterberg A. Routine ICU admission after brain tumor surgery: retrospective validation and critical appraisal of two prediction scores. Acta Neurochir. 2023 Jun 1;165(6):1655–64.

French J, Weber T, Ge B, Litofsky NS. Postoperative Delirium in Patients After Brain Tumor Surgery. World Neurosurgery. 2021 Nov 1;155:e472–9.

de Almeida CC, Boone MD, Laviv Y, Kasper BS, Chen CC, Kasper EM. The Utility of Routine Intensive Care Admission for Patients Undergoing Intracranial Neurosurgical Procedures: A Systematic Review. Neurocrit Care. 2018 Feb 1;28(1):35–42.

Nyholm L, Zetterling M, Elf K. Sleep in neurointensive care patients, and patients after brain tumor surgery. PLOS ONE. 2023 Jun 23;18(6):e0286389.

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Published

2024-05-10

How to Cite

Kusumawardani, D. I. ., & Adiyanto, B. . (2024). POST-OPERATIVE PROTOCOL FOR BRAIN TUMOR SURGERY IN INTENSIVE CARE UNIT: A LITERATURE REVIEW. Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10(5), 61-67. https://doi.org/10.61841/vv043b66