Manejo postoperatorio de resección de tumores cerebrales en la unidad de cuidado intensivo

Abstract

Neurosurgical procedures are considered major surgeries with potential complications that can be fatal or disabling, so postoperative care must be strict and systematic. Although it has always been believed that the care of these surgeries should be in the intensive care unit, the current trend has changed, making it possible to better select those patients who require monitoring in high dependency units. One of the main objectives in the postoperative care of patients undergoing elective craniectomy for brain tumors is maintaining homeostasis to promote recovery and reduce brain damage secondary to surgical trauma, in addition to quickly identifying neurological deterioration to carry out therapeutic behaviors that make it possible to establish immediate adequate medical treatment and communication with neurosurgery in the event that complications of a surgical nature that require reoperation are identified. Clinical evaluation and close follow-up take precedence over requesting diagnostic images, since serious complications will compromise the patient's neurological status. The implementation of enhanced recovery after surgery protocols to improve postoperative results, reduce hospital stay, costs and promote rehabilitation has become one of the most outstanding strategies in recent years for the care of neurosurgical patients. Multidisciplinary work must be the basis for achieving all the care and recovery objectives of the most complex patients admitted to the intensive care unit.