How is bacterial meningitis treated in neuro ICU
How is bacterial meningitis managed in adults in the neuro ICU?
In patients with a high risk of brain herniation, consider monitoring ICP and administering intermittent doses of osmotic diuretics (mannitol [25%] or hypertonic [3%] saline) to maintain an ICP of <15 mm Hg and a cerebral perfusion pressure of ≥60 mm Hg.
Initiate repeated lumbar puncture, lumbar drain, or ventriculostomy in patients with acute hydrocephalus. EEG monitoring is recommended in patients with a history of seizures and fluctuating scores on the GCS.
Either intubate or provide noninvasive ventilation in patients with worsening consciousness (clinical and laboratory indicators for intubation include poor cough and pooling secretions, a respiratory rate of >35 per minute, arterial oxygen saturation of <90% or arterial partial pressure of oxygen of <60 mm Hg, and arterial partial pressure of carbon dioxide of >60 mm Hg) as indicated under general care above.
All general principles of ICU care as mentioned above should be followed.
