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https://www.readbyqxmd.com/read/28087091/effect-of-single-dose-of-tolvaptan-in-neurocritical-patients-with-hyponatremia-due-to-syndrome-of-inappropriate-antidiuretic-hormone-secretion
#1
J A Llompart-Pou, J Pérez-Bárcena, M Novo, J M Raurich
No abstract text is available yet for this article.
January 10, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28054289/procalcitonin-is-a-poor-predictor-of-non-infectious-fever-in-the-neurocritical-care-unit
#2
Karin Halvorson, Sameer Shah, Corey Fehnel, Bradford Thompson, N Stevenson Potter, Mitchell Levy, Linda Wendell
BACKGROUND: Fever is a common occurrence in the Neurocritical Care Unit (NCCU). It is reported that up to 50 % of these fevers are associated with a non-infectious source. As this is a diagnosis of exclusion, a complete fever evaluation must be done to rule out infection. Procalcitonin (PCT) has been identified as a possible biomarker to distinguish infectious from non-infectious etiologies of fever. We hypothesized that PCT could be used as a predictor of infectious fever in febrile patients with intracranial hemorrhage admitted to the NCCU...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28054285/drug-interactions-in-neurocritical-care
#3
Brian Spoelhof, Salia Farrokh, Lucia Rivera-Lara
Drug-drug interactions (DDIs) are common and avoidable complications that are associated with poor patient outcomes. Neurocritical care patients may be at particular risk for DDIs due to alterations in pharmacokinetic profiles and exposure to medications with a high DDI risk. This review describes the principles of DDI pharmacology, common and severe DDIs in Neurocritical care, and recommendations to minimize adverse outcomes. A review of published literature was performed using PubMed by searching for 'Drug Interaction' and several high DDI risk and common neurocritical care medications...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28042365/variations-in-strategies-to-prevent-ventriculostomy-related-infections-a-practice-survey
#4
Ariane Lewis, Barry M Czeisler, Aaron S Lord
BACKGROUND AND PURPOSE: The ideal strategy to prevent infections in patients with external ventricular drains (EVDs) is unclear. METHODS: We conducted a cross-sectional survey of members of the Neurocritical Care Society on infection prevention practices for patients with EVDs between April and July 2015. RESULTS: The survey was completed by 52 individuals (5% response rate). Catheter selection, use of prolonged prophylactic systemic antibiotics (PPSAs), cerebrospinal fluid (CSF) collection policies, location of EVD placement, and performance of routine EVD exchanges varied...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28042364/predictors-of-acute-kidney-injury-in-neurocritical-care-patients-receiving-continuous-hypertonic-saline
#5
Michael J Erdman, Heidi Riha, Lauren Bode, Jason J Chang, G Morgan Jones
BACKGROUND AND PURPOSE: Continuous intravenous 3% hypertonic saline (HTS) infusions are commonly used for the management of cerebral edema following severe neurologic injuries. Despite widespread use, data regarding the incidence and predictors of nephrotoxicity are lacking. The purpose of this study was to describe the incidence and identify predictors of acute kidney injury (AKI) in neurocritical care patients administered continuous infusion HTS. METHODS: This was an institutional review board-approved, multicenter, retrospective cohort study of patients receiving HTS infusions at 2 academic medical centers...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#6
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28004334/noninvasive-neuromonitoring-current-utility-in-subarachnoid-hemorrhage-traumatic-brain-injury-and-stroke
#7
Luisa Vinciguerra, Julian Bösel
Noninvasive neuromonitoring is increasingly being used to monitor the course of primary brain injury and limit secondary brain damage of patients in the neurocritical care unit. Proposed advantages over invasive neuromonitoring methods include a lower risk of infection and bleeding, no need for surgical installation, mobility and portability of some devices, and safety. The question, however, is whether noninvasive neuromonitoring is practical and trustworthy enough already. We searched the recent literature and reviewed English-language studies on noninvasive neuromonitoring in subarachnoid hemorrhage, traumatic brain injury, and ischemic and hemorrhagic stroke between the years 2010 and 2015...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28004327/nutritional-and-bioenergetic-considerations-in-critically-ill-patients-with-acute-neurological-injury
#8
Peter A Abdelmalik, Susan Dempsey, Wendy Ziai
The brain, due to intensive cellular processes and maintenance of electrochemical gradients, is heavily dependent on a constant supply of energy. Brain injury, and critical illness in general, induces a state of increased metabolism and catabolism, which has been proven to lead to poor outcomes. Of all the biochemical interventions undertaken in the ICU, providing nutritional support is perhaps one of the most undervalued, but potentially among the safest, and most effective interventions. Adequate provisions of calories and protein have been shown to improve patient outcomes, and guidelines for the nutritional support of the critically ill patient are reviewed...
December 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28000129/management-of-external-ventricular-drains-after-subarachnoid-hemorrhage-a-multi-institutional-survey
#9
David Y Chung, Thabele M Leslie-Mazwi, Aman B Patel, Guy A Rordorf
BACKGROUND: Patients with aneurysmal subarachnoid hemorrhage (SAH) often develop hydrocephalus requiring an external ventricular drain (EVD). The best available evidence suggests that a rapid EVD wean and intermittent CSF drainage is safe, reduces complications, and shortens ICU and hospital length of stay as compared to a gradual wean and continuous drainage. However, optimal EVD management remains controversial and the baseline practice among neurological ICUs is unclear. Therefore, we sought to determine current institutional practices of EVD management for patients with aneurysmal SAH...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27992852/paracetamol-in-fever-in-critically-ill-patients-an-update
#10
REVIEW
D Chiumello, M Gotti, G Vergani
Fever, which is arbitrary defined as an increase in body temperature above 38.3°C, can affect up to 90% of patients admitted in intensive care unit. Induction of fever is mediated by the release of pyrogenic cytokines (tumor necrosis factor α, interleukin 1, interleukin 6, and interferons). Fever is associated with increased length of stay in intensive care unit and with a worse outcome in some subgroups of patients (mainly neurocritically ill patients). Although fever can increase oxygen consumption in unstable patients, on the contrary, it can activate physiologic systems that are involved in pathogens clearance...
November 5, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27965228/safety-of-continuous-peripheral-infusion-of-3-sodium-chloride-solution-in-neurocritical-care-patients
#11
G Morgan Jones, Lauren Bode, Heidi Riha, Michael J Erdman
BACKGROUND: Numerous drug information resources recommend that continuous intravenous 3% sodium chloride solution be administered via a central catheter. OBJECTIVES: To evaluate the incidence of infusion-related reactions and electrolyte abnormalities in neurocritical care patients treated with continuous intravenous infusion of 3% sodium chloride solution via a peripheral catheter. METHODS: Data on patients treated with continuous intravenous infusion of 3% sodium chloride solution at 2 academic medical centers were evaluated retrospectively to determine the administration site...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27960070/comparison-of-two-surface-cooling-devices-for-temperature-management-in-a-neurocritical-care-unit
#12
Gurpreet Singh Aujla, Premkumar Nattanmai, Keerthivaas Premkumar, Christopher R Newey
Fever increases mortality and morbidity and length of stay in neurocritically ill patients. Various methods are used in the neuroscience intensive care unit (NSICU) to control fever. Two such methods involve the Arctic Sun hydrogel wraps and the Gaymar cooling wraps. The purpose of our study was to compare these two methods in neurocritical care patients who had temperature >37.5°C for more than three consecutive hours and that was refractory to standard treatments. Data of patients requiring cooling wraps for treatment of hyperthermia at an NSICU at an academic, tertiary referral center were retrospectively reviewed...
December 13, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27930420/performance-of-spectrogram-based-seizure-identification-of-adult-eegs-by-critical-care-nurses-and-neurophysiologists
#13
Edilberto Amorim, Craig A Williamson, Lidia M V R Moura, Mouhsin M Shafi, Nicolas Gaspard, Eric S Rosenthal, Mary M Guanci, Venkatakrishna Rajajee, M Brandon Westover
INTRODUCTION: Continuous EEG screening using spectrograms or compressed spectral arrays (CSAs) by neurophysiologists has shorter review times with minimal loss of sensitivity for seizure detection when compared with visual analysis of raw EEG. Limited data is available on the performance characteristics of CSA-based seizure detection by neurocritical care nurses. METHODS: This is a prospective, cross-sectional study that was conducted in two academic neurocritical care units and involved thirty-three neurointensive care unit nurses and four neurophysiologists...
December 3, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27922259/development-of-neurocritical-care-enhanced-neuromonitoring-or-better-specialists-cooperation
#14
Nicolas Bruder, Salah Boussen, Lionel Velly
No abstract text is available yet for this article.
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27907968/palliative-care-practice-in-neurocritical-care
#15
Andrea K Knies, David Y Hwang
Many neurocritically ill patients and their families have high amounts of palliative care needs. Multiple professional societies relevant to neurocritical care have released consensus statements on meeting palliative care needs in neuroscience intensive care units. In this review, the authors discuss the ongoing debate regarding what model of palliative care delivery is optimal, focus on the process of shared decision making during goals-of-care discussions, and briefly comment on transitions from intensive care to comfort care...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907963/optimizing-medication-outcomes-in-neurocritical-care-focus-on-clinical-pharmacology
#16
Denise H Rhoney, Kathryn Morbitzer, Jimmi Hatton-Kolpek
Drug dosing in neurocritically ill patients presents enormous challenges for clinicians due to the complex pathophysiological alterations. These alterations are dynamic both between and within patients. Unpredictable exposure from standard dosing regimens, which were extrapolated to intensive care unit patients from healthy volunteer studies, may influence medication outcomes. Knowledge of potential alterations in pharmacokinetics/pharmacodynamics in these patients could be applied to maximize the clinical response and minimize adverse effects...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907960/multimodality-monitoring-illuminating-the-comatose-human-brain
#17
Charles L Francoeur, Margaret Pain, Stephan A Mayer
The field of neurocritical care has evolved tremendously in recent years, a development explained vastly by the advent of neurophysiological monitoring. From basic intracranial pressure measurements to brain tissue oxygenation, microdialysis, cerebral blood flow (CBF), and surface and intracortical electroencephalography (EEG), our ability to detect and control physiologic endpoints of brain function in comatose patients has grown substantially. The integration of these data gave birth to the concept of multimodality monitoring (MMM)...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907955/decompressive-craniectomy-in-neurocritical-care
#18
Erik G Hayman, David B Kurland, Zachary Grunwald, Sebastian Urday, Kevin N Sheth, J Marc Simard
Neurosurgeons increasingly use decompressive craniectomy (DC) in neurocritical care. In this review, the authors summarize the topic of DC for the neurointensivist. Following a brief overview of the procedure, the major indications for the procedure are described. This includes a review of the literature regarding well-established indications, such as infarction and traumatic brain injury, as well as lesser known indications, including intracerebral hemorrhage, ruptured cerebrovascular malformations, sinus thrombosis, and infection...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#19
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907951/neurocritical-care-and-emergency-neurology
#20
Kevin N Sheth
No abstract text is available yet for this article.
December 2016: Seminars in Neurology
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