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Neurological icu

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https://www.readbyqxmd.com/read/29219759/does-the-obesity-paradox-predict-functional-outcome-in-intracerebral-hemorrhage
#1
Neha S Dangayach, Harpreet Singh Grewal, Gian Marco De Marchis, Roberta K Sefcik, Rachel Bruce, Aarti Chhatlani, E Sander Connolly, M Cristina Falo, Sachin Agarwal, Jan Claassen, J Michael Schmidt, Stephan A Mayer
OBJECTIVE Being overweight or mildly obese has been associated with a decreased risk of death or hospitalization in patients with cardiovascular disease. Similarly, overweight patients admitted to an intensive care unit (ICU) have improved survival up to 1 year after admission. These counterintuitive observations are examples of the "obesity paradox." Does the obesity paradox exist in patients with intracerebral hemorrhage (ICH)? In this study the authors examined whether there was an association between obesity and functional outcome in patients with ICH...
December 8, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#2
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-case-report
#3
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
BACKGROUND: Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy. CASE REPORT: We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis...
December 8, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29215400/five-year-survival-and-causes-of-death-in-children-after-intensive-care-a-national-registry-study
#4
Elina Kyösti, Janne H Liisanantti, Outi Peltoniemi, Pasi Ohtonen, Paula Rautiainen, Janne Kataja, Tero Ala-Kokko
OBJECTIVES: The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age. DESIGN: Longitudinal follow-up study. SETTING: Registry study of a national ICU register and hospital registries. PATIENTS: Children admitted to an ICU in the years 2009 and 2010. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The mortality and causes of death following ICU discharge were analyzed retrospectively...
December 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29215368/numeracy-and-interpretation-of-prognostic-estimates-in-intracerebral-hemorrhage-among-surrogate-decision-makers-in-the-neurologic-icu
#5
Nikita Leiter, Melissa Motta, Robert M Reed, Temitope Adeyeye, Debra L Wiegand, Nirav G Shah, Avelino C Verceles, Giora Netzer
OBJECTIVE: Clinicians caring for patients with intracerebral hemorrhage must often discuss prognosis and goals of care with their patients' surrogate decision makers, and may make numeric estimates of likelihood of survival and functional independence, informed by validated prediction models. Surrogates' prognostic estimates are often discordant with physicians', suggesting that physicians' numeric statements may not be accurately interpreted. We sought to assess the relationship between numeracy and interpretation of prognostic estimates in intracerebral hemorrhage among surrogate decision makers...
December 5, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29214598/evaluation-of-a-wireless-portable-wearable-multi-parameter-vital-signs-monitor-in-hospitalized-neurological-and-neurosurgical-patients
#6
Robert S Weller, Kristina L Foard, Timothy N Harwood
Unrecognized changes in patients' vital signs can result in preventable deaths in hospitalized patients. Few publications or studies instituting routine patient monitoring have described implementation and the setting of alarm parameters for vital signs. We wanted to determine if continuous multi-parameter patient monitoring can be accomplished with an alarm rate that is acceptable to hospital floor nurses and to compare the rate of patient deterioration events to those observed with routine vital sign monitoring...
December 6, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29207432/-sonography-of-the-optic-nerve-a-new-bedside-tool-in-intensive-care
#7
Christopher Hohmann, Konrad R Koch, Roman Pfister, Guido Michels
History and clinical findings Here, we present the case history of a 76-year old man with out-of-hospital cardiac arrest due to a cardiogenic shock and a consecutive no-flow-time of approximately 10 minutes. After 25 minutes of resuscitation procedures a spontaneous return of circulation could be established. The patient was admitted to our center for emergency coronary angiography. After coronary stenting the patient was admitted to our intensive care unit and treated in accordance with the guidelines on cardiogenic shock due to myocardial infarction...
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29203503/multicentre-prospective-randomised-single-blind-controlled-study-protocol-of-the-effect-of-an-additional-parent-administered-sensorimotor-stimulation-on-neurological-development-of-preterm-infants-primebrain
#8
Karine Pelc, Irit Daniel, Bernard Wenderickx, Bernard Dan
INTRODUCTION: Preterm and very low birthweight infants are at increased risk for neurodevelopmental disorders, including cerebral palsy, sensory impairment and intellectual disability. Several early intervention approaches have been designed in the hope of optimising neurological development in this context. It seems important that the intervention takes into account parental mental health, focuses on parent-child interactions and lasts sufficiently long. This study aims to evaluate the effects of a stimulation programme administered by parents until 6 months post-term on motor and neurophysiological development of infants born preterm...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29202613/the-effects-of-infection-on-severe-stroke-patients-in-the-neurological-intensive-care-unit-in-china
#9
Heyin Mi, Shujuan Li, Haiying Li, Wenli Hu
OBJECTIVE: To study the effects of infection on severe stroke patients in the Neurological Intensive Care Unit (NICU) and to find the related risk factors for mortality of severe stroke patients. METHODS: We conducted a retrospective study including 343 patients with ischemic or hemorrhagic stroke and staying more than 2 patient-days in the NICU at Beijing Chaoyang Hospital from January 2011 to December 2015 to analyze the infection features of patients with severe stroke in the Neurological Intensive Care Unit...
December 5, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29201544/occurrence-of-overt-seizures-in-comatose-survivor-patients-treated-with-targeted-temperature
#10
Anda Eilam, Volodymyr Samogalskyi, Gennady Bregman, Sarit Eliner-Avishai, Ronit Gilad
Background: Unconscious patients after out-of-hospital cardiac arrest have a high risk of death. Therapeutic hypothermia is recommended by international resuscitation guidelines in order to attenuate secondary destructive physiological processes such as reperfusion injury, apoptosis, and cerebral edema. The target temperature to reach ranges between 32 and 34°C for at least 24 hr. Hypothermia can induce metabolic disturbances. There are some reports in the literature indicating the presence of seizures during targeted temperature management...
November 2017: Brain and Behavior
https://www.readbyqxmd.com/read/29194171/improving-the-accuracy-of-delirium-assessments-in-neuroscience-patients-scaling-a-quality-improvement-program-to-improve-nurses-skill-compliance-and-accuracy-in-the-use-of-the-confusion-assessment-method-in-the-intensive-care-unit-tool
#11
Justin DiLibero, Susan DeSanto-Madeya, Rachael Dottery, Lauren Sullivan, Sharon C O'Donoghue
BACKGROUND: Delirium affects up to 80% of critically ill patients; however, many cases of delirium go unrecognized because of inaccurate assessments. The effectiveness of interventions to improve assessment accuracy among the general population has been established, but assessments among neuroscience patients are uniquely complicated due to the presence of structural neurologic changes. OBJECTIVES: The purposes of this quality improvement project were to improve the accuracy of nurse's delirium assessments among neuroscience patients and to determine the comparative effectiveness of the intervention between medical and neuroscience patients...
January 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29194079/compliance-with-best-practice-guidelines-for-neurodevelopmental-supportive-care-in-south-africa-a-situational-analysis
#12
Aletta Rheeder, Welma Lubbe, Christa S J van der Walt, Ronel Pretorius
Neurodevelopmental supportive care provides preterm infants with evidence-based care to ensure the best possible neurological outcomes. The study aimed to determine the compliance of current nursing care practices with best practice guidelines by means of a situational analysis. The situational analysis was done in 2 cycles in the neonatal intensive care units (n = 25) of a private healthcare provider in South Africa. Structured observations were done in cycle 1 using the Implementation of Neurodevelopmental Supportive Care checklist...
November 30, 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#13
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
December 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29188763/prothrombotic-state-in-a-patient-with-acute-liver-failure-the-question-of-anticoagulation
#14
Ecaterina Scărlă Tescu, Dana Rodica Tomescu
A 35-year-old male with acute liver failure due to acute hepatitis B virus infection was admitted to the intensive care unit with significant hepatocellular injury, cholestasis, abnormal standard coagulation tests, normal rotational thromboelastometry indices, and without signs of bleeding. He underwent emergency liver transplantation without requiring blood product transfusions or procoagulant treatments. The postoperative course was complicated by deep vein thrombosis and impending hepatic artery thrombosis treated with unfractionated heparin, aspirin, and intravenous prostacyclin...
November 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29181551/-metabolic-disorders-as-paraneoplastic-syndromes
#15
REVIEW
S Krug, P Michl
Paraneoplastic syndromes are characterized by the tumor-induced release of peptide hormones and/or the initiation of immune phenomena, which elicit clinical changes and alterations in laboratory parameters independent of the tumor size and spread. In addition to neurological, endocrinal and rheumatological phenotypes, metabolic alterations play a special role in the clinical routine as they commonly present with acute symptoms in an emergency situation and necessitate immediate diagnosis and prompt initiation of treatment...
November 27, 2017: Der Internist
https://www.readbyqxmd.com/read/29174722/functional-progression-of-patients-with-neurological-diseases-in-a-tertiary-paediatric-intensive-care-unit-our-experience
#16
P Madurga Revilla, J López Pisón, P Samper Villagrasa, J P García Íñiguez, R Garcés Gómez, M Domínguez Cajal, I Gil Hernández
INTRODUCTION: Neurological diseases explain a considerable proportion of admissions to paediatric intensive care units (PICU), and are a significant cause of morbidity and mortality. This study aims to analyse the functional progression of children with critical neurological conditions. MATERIAL AND METHODS: Retrospective descriptive study of children admitted to PICU with neurological diseases over a period of 3 years (2012-2014), assessing vital and functional prognosis at PICU discharge and at one year according to the Pediatric Cerebral and Overall Performance Category scales (PCPC-POPC) and the Functional Status Scale (FSS)...
November 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29163364/telomere-length-in-preterm-infants-a-promising-biomarker-of-early-adversity-and-care-in-the-neonatal-intensive-care-unit
#17
Livio Provenzi, Giunia Scotto di Minico, Roberto Giorda, Rosario Montirosso
Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), which is thought to grant at-risk newborns' survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29162037/icu-treated-influenza-a-h1n1-pdm09-infections-more-severe-post-pandemic-than-during-2009-pandemic-a-retrospective-analysis
#18
Pekka Ylipalosaari, Tero I Ala-Kokko, Jouko Laurila, Lauri Ahvenjärvi, Hannu Syrjälä
BACKGROUND: We compared in a single mixed intensive care unit (ICU) patients with influenza A(H1N1) pdm09 between pandemic and postpandemic periods. METHODS: Retrospective analysis of prospectively collected data in 2009-2016. Data are expressed as median (25th-75th percentile) or number (percentile). RESULTS: Seventy-six influenza A(H1N1) pdm09 patients were admitted to the ICU: 16 during the pandemic period and 60 during the postpandemic period...
November 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29161899/how-long-should-routine-eeg-be-recorded-to-get-relevant-information
#19
Hannah Doudoux, Kristina Skaare, Thomas Geay, Philippe Kahane, Jean L Bosson, Cécile Sabourdy, Laurent Vercueil
OBJECTIVE: The optimal duration of routine EEG (rEEG) has not been determined on a clinical basis. This study aims to determine the time required to obtain relevant information during rEEG with respect to the clinical request. METHOD: All rEEGs performed over 3 months in unselected patients older than 14 years in an academic hospital were analyzed retrospectively. The latency required to obtain relevant information was determined for each rEEG by 2 independent readers blinded to the clinical data...
March 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29158060/meta-analysis-of-the-outcome-after-postcardiotomy-venoarterial-extracorporeal-membrane-oxygenation-in-adult-patients
#20
Fausto Biancari, Andrea Perrotti, Magnus Dalén, Mariapia Guerrieri, Antonio Fiore, Daniel Reichart, Angelo M Dell'Aquila, Giuseppe Gatti, Tero Ala-Kokko, Eeva-Maija Kinnunen, Tuomas Tauriainen, Sidney Chocron, Juhani K E Airaksinen, Vito G Ruggieri, Debora Brascia
OBJECTIVE: This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN: Systematic review of the literature and meta-analysis. SETTING: Multi-institutional study. PARTICIPANTS: Adult patients with acute heart failure immediately after cardiac surgery. INTERVENTIONS: VA-ECMO after cardiac surgery...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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