gms | German Medical Science

128. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

03.05. - 06.05.2011, München

Monitoring of patients after brain tumor surgery in an Intermidiate Care Unit setting

Meeting Abstract

  • Jan Gerhard Welker - Klinikum Nürnberg, Klinik für Neurochirurgie, Nürnberg
  • Matthias Hohenhaus - Klinikum Nürnberg, Klinik für Anästhesiologie und Intensivmedizin, Nürnberg
  • Markus Neher - Klinikum Nürnberg, Klinik für Neurochirurgie, Nürnberg
  • Martin Wenzel - Klinikum Nürnberg, Klinik für Anästhesiologie und Intensivmedizin, Nürnberg
  • Hans Herbert Steiner - Klinikum Nürnberg, Klinik für Neurochirurgie, Nürnberg

Deutsche Gesellschaft für Chirurgie. 128. Kongress der Deutschen Gesellschaft für Chirurgie. München, 03.-06.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11dgch682

DOI: 10.3205/11dgch682, URN: urn:nbn:de:0183-11dgch6823

Published: May 20, 2011

© 2011 Welker et al.
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Outline

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Introduction: Compared to general ward an Intermediate Care Unit (IMC) offers better monitoring and treatment options. Due to this and because of a cost advantage in comparison to a classical Intensive Care Unit (ICU) it could be an economical alternative to ICU. After brain tumor surgery patients usually are observed on ICU. The aim of this study was to evaluate, wether an IMC can provide monitoring of patients after elective brain tumor surgery at the same level as an ICU concerning treatment-quality and patient-safety and due to this help economizing ICU-capacity.

Material and methods: In this prospective study patients were extubated immediately after intracranial tumor surgery and then monitored on IMC. The decision criteria for IMC rather than ICU were mainly the intraoperative process and anesthetical extubation-criteria. Until now 50 patients have been monitored on IMC after surgery. The surgery indicating diagnosis was meningeoma (13/50), brain metastasis (9/50), glioblastoma (8/50), pituitary-tumor (7/50), cavernoma (4/50), astrocytoma (2/50) and others (7/50).

Results: No complications occurred during surgery (0/50), the extubation-criteria were achieved in each case (50/50). On IMC minor events (hypertensive crisis (4/50), respiratory depression (2/50), cardiac arrhythmia (3/50), hyponatremia (1/50)) were detected and managed in ten cases (10/50). After an overnight stay 49 patients could be transferred to general ward clinically stabile (49/50). The necessity of re-intubation and transfer to ICU occurred in one case (1/50), because of non-surgical complications.

Conclusion: To this point the data of the current study shows that an IMC can provide monitoring of patients after elective brain tumor surgery under set selection-criteria. Under these circumstances an IMC seems to be an alternative to an ICU in regard to quality and safety. Furthermore it is most likely that treatment of this kind of patients on IMC rather than ICU could end in economic benefit.