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https://www.readbyqxmd.com/read/30553457/do-contradictions-in-tqip-measures-affect-perceptions-of-quality-an-analysis-of-tqip-definitions-on-quality-outcomes-for-placement-of-icp-monitoring-at-a-single-level-one-trauma-center
#1
Jonathan Weyerbacher, Lewis Jacobson, Jonathan Saxe
BACKGROUND: TQIP quality measures as currently defined on occasion provide discordant conclusions. A recent TQIP report of an urban level one-trauma center suggested a low employment of ICP monitoring while also demonstrating aggressive implementation of ICP monitoring (ave. within 90 min of arrival). This apparent contradiction leads to the question; Does TQIP define correctly the patient cohort who would most benefit from ICP monitoring? METHODS: A retrospective IRB approved review of all patients reported to TQIP with severe TBI was performed at an ACS verified level one trauma center...
October 28, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/30532327/perioperative-monitoring-of-intracranial-pressure-using-optic-nerve-sheath-diameter-in-paediatric-liver-transplantation
#2
Atish Pal, Purnima Dhar, Neerav Goyal
An elevation of intracranial pressure (ICP) secondary to cerebral oedema is a major contributor to morbidity and mortality in acute liver failure (ALF). We present a case of ICP monitoring with ocular ultrasonography in a 2-year-old child with ALF for liver transplantation. Since invasive ICP monitoring was risky considering the level of coagulopathy, optic nerve sheath diameter (ONSD) monitoring was done by ultrasound. A value of 4.5 mm was chosen as the cut-off for an ICP >20 mmHg in this child and was checked at regular intervals during the surgery...
November 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/30530262/airway-pressure-release-ventilation-does-not-increase-intracranial-pressure-in-patients-with-traumatic-brain-injury-with-poor-lung-compliance
#3
Colston A Edgerton, Stuart M Leon, Melissa A Hite, Stephen P Kalhorn, Lancer A Scott, Evert A Eriksson
The use of Airway Pressure Release Ventilation (APRV) in patients with traumatic brain injury (TBI) remains controversial. Some believe that elevated mean airway pressures transmitted to the thorax may cause clinically significant increases in Central Venous Pressure (CVP) and intracranial pressure (ICP) from venous congestion. We perform a retrospective review from 2009 to 2015 of traumatically injured patients who were transitioned from traditional ventilator modes to APRV and also had an ICP monitor in place...
December 3, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30528524/use-of-anti-coagulation-agents-after-traumatic-intracranial-hemorrhage
#4
Anthony Divito, Keith Kerr, Christopher Wilkerson, Scott Shepard, Alex Choi, Ryan Kitagawa
OBJECTIVES: Anticoagulant therapy (ACT) after traumatic intracranial hemorrhage may lead to progression of hemorrhage, but in the presence of thromboembolic events the clinician must decide if the benefits outweigh the risks. Currently, no data exist to guide therapy in the acute setting. PATIENTS AND METHODS: We retrospectively identified all patients admitted to our institution with traumatic intracranial hemorrhage that received intravenous heparin, full dose enoxaparin, or warfarin during their initial hospitalization over a three-year period...
December 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30523541/cerebral-vascular-changes-during-acute-intracranial-pressure-drop
#5
Xiuyun Liu, Lara L Zimmermann, Nhi Ho, Paul Vespa, Xiaoling Liao, Xiao Hu
OBJECTIVE: This study applied a new external ventricular catheter, which allows intracranial pressure (ICP) monitoring and cerebral spinal fluid (CSF) drainage simultaneously, to study cerebral vascular responses during acute CSF drainage. METHODS: Six patients with 34 external ventricular drain (EVD) opening sessions were retrospectively analyzed. A published algorithm was used to extract morphological features of ICP recordings, and a template-matching algorithm was applied to calculate the likelihood of cerebral vasodilation index (VDI) and cerebral vasoconstriction index (VCI) based on the changes of ICP waveforms during CSF drainage...
December 6, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30511386/intracranial-pressure-during-hemodialysis-in-patients-with-acute-brain-injury
#6
Anton Lund, Mette B Damholt, Jørgen Wiis, Jesper Kelsen, Ditte G Strange, Kirsten Møller
BACKGROUND: Because osmotic fluid shifts may occur over the blood-brain barrier, patients with acute brain injury are theoretically at risk of surges in intracranial pressure (ICP) during hemodialysis. However, this remains poorly investigated. We studied changes in ICP during hemodialysis in such patients. METHODS: We performed a retrospective study of patients with acute brain injury admitted to Rigshospitalet (Copenhagen, Denmark) from 2012 to 2016 who received intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) while undergoing ICP monitoring...
December 3, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/30511345/evaluation-of-a-new-catheter-for-simultaneous-intracranial-pressure-monitoring-and-cerebral-spinal-fluid-drainage-a-pilot-study
#7
Xiuyun Liu, Lara L Zimmermann, Nhi Ho, Paul Vespa, Xiaoling Liao, Xiao Hu
OBJECTIVES: Intracranial pressure (ICP) monitoring is a common practice when treating intracranial pathology with risk of elevated ICP. External ventricular drain (EVD) insertion is a standard approach for both monitoring ICP and draining cerebrospinal fluid (CSF). However, the conventional EVD cannot serve these two purposes simultaneously because it cannot accurately measure ICP and its pulsatile waveform while the EVD is open to CSF drainage. A new Integra® Camino® FLEX Ventricular Catheter (Integra Lifesciences, County Offaly, Ireland) with a double-lumen construction has been recently introduced into the market, and it can monitor ICP waveforms even during CSF drainage...
December 3, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30476233/twenty-five-years-of-intracranial-pressure-monitoring-after-severe-traumatic-brain-injury-a-retrospective-single-center-analysis
#8
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Danilo Cardim, Angelos G Kolias, Frederick A Zeiler, Andrea Lavinio, Marcel Aries, Chiara Robba, Peter Smielewski, Peter J A Hutchinson, David K Menon, John D Pickard, Karol P Budohoski
BACKGROUND: Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period has also seen changes in management strategies with the implementation of protocolled specialist neurocritical care, expansion of neuromonitoring techniques, and adjustments of clinical treatment targets. OBJECTIVE: To describe the changes in intracranial monitoring variables over the past 25 yr...
November 23, 2018: Neurosurgery
https://www.readbyqxmd.com/read/30406315/a-precision-medicine-approach-to-cerebral-edema-and-intracranial-hypertension-after-severe-traumatic-brain-injury-quo-vadis
#9
REVIEW
Ruchira M Jha, Patrick M Kochanek
PURPOSE OF REVIEW: Standard clinical protocols for treating cerebral edema and intracranial hypertension after severe TBI have remained remarkably similar over decades. Cerebral edema and intracranial hypertension are treated interchangeably when in fact intracranial pressure (ICP) is a proxy for cerebral edema but also other processes such as extent of mass lesions, hydrocephalus, or cerebral blood volume. A complex interplay of multiple molecular mechanisms results in cerebral edema after severe TBI, and these are not measured or targeted by current clinically available tools...
November 7, 2018: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/30404096/impact-of-the-timing-of-placement-of-an-intracranial-pressure-monitor-on-outcomes-in-children-with-severe-traumatic-brain-injury
#10
Binod Balakrishnan, Liyun Zhang, Pippa M Simpson, Sheila J Hanson
BACKGROUND: Severe traumatic brain injury (sTBI) is the leading cause of morbidity and mortality from trauma. Brain Trauma Foundation guidelines recommend intracranial pressure (ICP) monitoring in sTBI. We hypothesized that early ICP monitor placement was associated with better outcomes in children. METHODS: This was a retrospective study of children with sTBI admitted to the participating pediatric intensive care units (PICUs) and entered into the Virtual Pediatric Systems (VPS), LLC, database between 1 January 2010 and 31 December 2015...
November 7, 2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30340972/neurointensive-care-of-patients-with-cerebral-venous-sinus-thrombosis-and-intracerebral-haemorrhage
#11
Jacob Wall, Per Enblad
The aim was to review the neurointensive care (NIC) of cerebral venous sinus thrombosis patients with haemorrhage during a 15-year period. This is a severe condition with substantial mortality caused by increased intracranial pressure (ICP) and studies are lacking describing the complex picture of the NIC, which offers a large treatment arsenal for intracranial hypertension. Patients treated 2000-2015 were investigated. Data regarding patient characteristics, symptoms, imaging, ICP-treatment, NIC-treatment intensity, and outcome were collected and analysed...
October 16, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/30334071/the-role-of-coagulopathy-on-clinical-outcome-following-traumatic-brain-injury-in-children-analysis-of-66-consecutive-cases-in-a-single-center-institution
#12
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
December 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30276652/conservative-and-operative-management-of-iatrogenic-craniocerebral-disproportion-a-case-based-review
#13
Thomas Beez, Christopher Munoz-Bendix, Sebastian Alexander Ahmadi, Martina Messing-Jünger, Hans-Jakob Steiger, Andreas Röhrig
INTRODUCTION: Craniocerebral disproportion (CCD) can occur as a sequela after shunting in early infancy. It can be understood as a disorder closely related to slit ventricle syndrome and chronic overdrainage syndrome. Here, we present two exemplary cases and summarize the pathophysiological, diagnostic, and therapeutic approaches to CCD. CLINICAL PRESENTATION: Two premature babies underwent shunting for posthemorrhagic hydrocephalus and presented in later childhood with recurrent episodes of symptomatic raised intracranial pressure (ICP) at 2 and 8 years of age, respectively...
October 2, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/30267207/telemetry-in-intracranial-pressure-monitoring-sensor-survival-and-drift
#14
Nicolas Hernandez Norager, Alexander Lilja-Cyron, Carsten Reidies Bjarkam, Sara Duus, Marianne Juhler
BACKGROUND: Telemetric intracranial pressure (ICP) monitoring enable long-term ICP monitoring on patients during normal day activities and may accordingly be of use during evaluation and treatment of complicated ICP disorders. However, the benefits of such equipment depend strongly on the validity of the recordings and how often the telemetric sensor needs to be re-implanted. This study investigates the clinical and technical sensor survival time and drift of the telemetric ICP sensor: Raumedic Neurovent-P-tel...
November 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30265194/a-clinical-decision-rule-to-predict-intracranial-hypertension-in-severe-traumatic-brain-injury
#15
Aziz S Alali, Nancy Temkin, Jason Barber, Jim Pridgeon, Kelley Chaddock, Sureyya Dikmen, Peter Hendrickson, Walter Videtta, Silvia Lujan, Gustavo Petroni, Nahuel Guadagnoli, Zulma Urbina, Randall M Chesnut
OBJECTIVE: While existing guidelines support the treatment of intracranial hypertension in severe traumatic brain injury (TBI), it is unclear when to suspect and initiate treatment for high intracranial pressure (ICP). The objective of this study was to derive a clinical decision rule that accurately predicts intracranial hypertension. METHODS: Using Delphi methods, the authors identified a set of potential predictors of intracranial hypertension and a clinical decision rule a priori by consensus among a group of 43 neurosurgeons and intensivists who have extensive experience managing severe TBI without ICP monitoring...
September 28, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30261393/intraoperative-measuring-of-the-vascular-pressure-on-the-facial-nerve-at-rez-in-hfs-patients-during-mvd-a-prospective-study
#16
Pei Zhang, M Helmy Selim, Haiyan Wang, Wei Kuang, Miaojing Wu, Chenxing Ji, Guowen Hu, Lei Wu, Xingen Zhu, Hua Guo
OBJECT: The compression of the offending vessel upon the facial nerve at root exit zone (REZ) is considered as the leading cause of hemifacial spasm (HFS). However, the correlation between the severity of spasm and the pressure of neurovascular compression (NVC) has not yet been investigated. The aim of this study was to investigate the clinical correlation between the severity of HFS and the pressure of NVC. METHODS: A prospective study was performed, which included 52/151 patients who underwent microvascular decompression (MVD)...
September 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30251919/ventricular-drainage-catheters-versus-intracranial-parenchymal-catheters-for-intracranial-pressure-monitoring-based-management-of-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#17
Victor Volovici, Jilske A Huijben, Ari Ercole, Nino Stocchetti, Clemens M F Dirven, Mathieu van der Jagt, Ewout W Steyerberg, Hester F Lingsma, David K Menon, Andrew I R Maas, Iain K Haitsma
Intracranial pressure (ICP) monitoring is one of the mainstays in the treatment of severe traumatic brain injury (TBI), but different approaches to monitoring exist. The aim of this systematic review and meta-analysis is to compare the effectiveness and complication rate of ventricular drainage (VD) versus intracranial parenchymal (IP) catheters to monitor and treat raised ICP in patients with TBI. Pubmed, Embase, Web of Science, Google Scholar, and the Cochrane Database were searched for articles comparing ICP monitoring-based management with VDs and monitoring with IP monitors through March 2018...
October 30, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/30251073/differentiate-the-source-and-site-of-intracranial-pressure-measurements-using-more-precise-nomenclature
#18
EDITORIAL
DaiWai M Olson, Stefany Ortega Peréz, Jonathan Ramsay, Chethan P Venkatasubba Rao, Jose I Suarez, Molly McNett, Venkatesh Aiyagari
BACKGROUND: Intracranial pressure (ICP) monitoring is fundamental for neurocritical care patient management. For many years, ventricular and parenchymal devices have been available for this aim. The purpose of this paper is to review the published literature comparing ICP recordings via an intraventricular catheter or an intraparenchymal (brain tissue) catheter. METHODS: Literature search of Medline, CINAHL, Embase, and Scopus was performed in which manuscripts discussed both ICP monitoring via an intraventricular catheter and ICP monitoring through intraparenchymal (brain tissue) catheter...
September 24, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30215559/intracranial-pressure-elevations-in-diffuse-axonal-injury-association-with-nonhemorrhagic-mr-lesions-in-central-mesencephalic-structures
#19
Sami Abu Hamdeh, Niklas Marklund, Anders Lewén, Tim Howells, Raili Raininko, Johan Wikström, Per Enblad
OBJECTIVE Increased intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) with diffuse axonal injury (DAI) is not well defined. This study investigated the occurrence of increased ICP and whether clinical factors and lesion localization on MRI were associated with increased ICP in patients with DAI. METHODS Fifty-two patients with severe TBI (median age 24 years, range 9-61 years), who had undergone ICP monitoring and had DAI on MRI, as determined using T2*-weighted gradient echo, susceptibility-weighted imaging, and diffusion-weighted imaging (DWI) sequences, were enrolled...
September 14, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/30181428/identifying-causal-relationships-between-eeg-activity-and-intracranial-pressure-changes-in-neurocritical-care-patients
#20
Ancor Sanz-García, Miriam Pérez-Romero, Jesús Pastor, Rafael G Sola, Lorena Vega-Zelaya, Fernando Monasterio, Carmen Torrecilla, Gema Vega, Paloma Pulido, Guillermo J Ortega
OBJECTIVE: To explore and assess the relationship between electroencephalography (EEG) activity and intracranial pressure (ICP) in patients suffering from traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) during their stay in an intensive care unit. APPROACH: We performed an observational prospective cohort study of adult patients suffering from TBI or SAH. Continuous EEG-ECG was performed during ICP monitoring. In every patient, variables derived from the EEG were calculated and the Granger causality (GC) methodology was employed to assess whether, and in which direction, there is any relationship between EEG and ICP...
September 5, 2018: Journal of Neural Engineering
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