ICU Management of Acute Ischemic Stroke

In this episode of Critical Matters, Dr. Sergio Zanotti interviews Dr. Sayona John about the critical care management of acute ischemic stroke. Dr. John provides an overview of which stroke patients need ICU care, emphasizing the importance of the NIH Stroke Scale for communication among healthcare providers. The discussion covers airway management, including intubation criteria and aspiration risk evaluation, as well as hemodynamic management, focusing on blood pressure autoregulation and the use of IV tPA and endovascular therapies. They delve into complications like cerebral edema and hemorrhagic transformation, detailing pharmacological and surgical interventions. Additional critical care considerations such as antiplatelet and anticoagulation therapies, temperature and glucose control, and early mobility are also addressed. Dr. John concludes by highlighting the importance of neurological exams and individualizing patient care, viewing medicine as an art informed by science.