CRITICAL CARE NEUROLOGY IN ACUTE STROKE UNITS

Abstract

Acute stroke units (ASUs) play a very prominent role where rapid assessment and treatment by neurologists directly influences the rate of recovery in people.  This paper utilized a mixed design of the experiment to investigate the effectiveness of neurocritical care procedures in ASUs. It accomplished that through the integration of physiological monitoring, biomarker analysis and qualitative assessments of the quality levels in team collaboration.  The brains of a bunch of acute ischemic stroke and hemorrhagic stroke patients (120) were monitored non-stop on arrival. These were intracranial pressure (ICP), Glasgow Coma Scale (GCS) and NIH Stroke Scale (NIHSS).  We calculated and monitored cerebral perfusion pressure (CPP) and we realized that they had better outcomes when the CPP was above 70 mmHg (p<0.01).  S100B and NSE levels were far higher in patients whose neurological condition was deteriorating.  Improved functional independence after discharge (increase of 25 percent) was attributed to hyperosmolar treatment and controlled hypothermia; both are forms of critical care.  The multivariate regression analysis showed that all measurements of ICP, CPP, biomarker levels were independent prognostic variables of survival after 30 days.  Formal interviews of the personnel in healthcare at the same time revealed the systemic issues of the escalation pathways. They were able to demonstrate, as well, that the interprofessional collaboration is the force in prompt response and continuity of care.  The integration of quantitative outcome modeling and qualitative systems analysis provided the entire image of how to advance the care of strokes.  It is with such results that adaptive ASU procedures can be developed that have telemetry and have the ability to react not only to the changing condition of the patient, as well as to changes in how the work is performed.