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https://www.readbyqxmd.com/read/27907968/palliative-care-practice-in-neurocritical-care
#1
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
#2
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
#3
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
#4
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
#5
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
#6
Kevin N Sheth
No abstract text is available yet for this article.
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27886628/eeg-utilization-in-canadian-intensive-care-units-a-multicentre-prospective-observational-study
#7
Andrea Park, Martin Chapman, Victoria A McCredie, Derek Debicki, Teneille Gofton, Loretta Norton, J Gordon Boyd
PURPOSE: We have previously shown that electroencephalography (EEG) may be an underutilized monitoring modality in a single general medical-surgical ICU, that does not have a specific neurocritical care consultation service or neurocritical care unit. The present study was designed to describe the pattern of EEG utilization across 3 academic ICUs in Ontario, Canada that use different models of neurocritical care. METHOD: In this prospective multicentre observational study, ICU patients were screened weekly for 6 non-consecutive weeks to determine if they met the ESICM's recommendations or suggestions for EEG monitoring...
November 13, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27858808/guideline-for-reversal-of-antithrombotics-in-intracranial-hemorrhage-executive-summary-a-statement-for-healthcare-professionals-from-the-neurocritical-care-society-and-the-society-of-critical-care-medicine
#8
Jennifer A Frontera, John J Lewin, Alejandro A Rabinstein, Imo P Aisiku, Anne W Alexandrov, Aaron M Cook, Gregory J Del Zoppo, Monisha Kumar, Ellinor I B Peerschke, Michael F Stiefel, Jeanne S Teitelbaum, Katja E Wartenberg, Cindy L Zerfoss
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#9
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27850761/1124-implementation-of-a-pediatric-neurocritical-care-program-at-a-large-children-s-medical-center
#10
Javier Gelvez, Traci Brooks, Candace Wilson, Abel Biesman, Linda Thompson
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850454/816-ninety-day-quality-of-life-and-withdrawal-of-care-across-the-neurocritical-care-unit
#11
Ray Scott, Erika Schlichter, Mitchell Singstock, Alisha Hodge, Daniel Kanter, Laura Ngwenya, Brandon Foreman, Simona Ferioli
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850406/768-desmopressin-for-antiplatelet-reversal-in-neurocritical-care
#12
Jeffrey Barletta, Claire Mankiewicz, Alicia Mangram, Joseph Sucher, Francis Ali-Osman, James Dzandu, Igor Yusupov, Victor Zach
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850358/720-outcome-effect-of-dedicated-neurocritical-care-icus-after-brain-injury-a-multicenter-cohort-study
#13
Varoon Thavapalan, Shaista Alam, Fred Rincon
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850227/587-outcomes-after-percutaneous-endoscopic-gastrostomy-in-neurocritical-care-patients
#14
Andreea Xavier, Kim Vu, Jade Woellner, Stephanie Cooper, Maria DeGuzmann, Hope Moser, Jeremy Ragland, Huimahn Choi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849864/222-increased-rate-and-earlier-onset-of-picc-related-thrombosis-in-neurocritical-patients
#15
Myrna Wallace-Servera, Steve Hartzman, Stuart Braverman, Manu Singh
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27844465/blood-flow-diversion-as-a-primary-treatment-method-for-ruptured-brain-aneurysms-concerns-controversy-and-future-directions
#16
Brian P Walcott, Matthew J Koch, Christopher J Stapleton, Aman B Patel
Flow diversion is a novel treatment for brain aneurysms that works by redirecting blood flow away from the aneurysm. Immediately after placement of the stent, blood flow stagnates within the aneurysm dome and it undergoes thrombosis. Over time, a new endothelium develops across the neck, thereby reconstructing the parent vessel and curing the aneurysm. The use of this treatment method for ruptured aneurysms has two specific concerns: 1) risk of hemorrhage from the aneurysm after treatment because of potential delayed aneurysm occlusion; and 2) hemorrhagic complications from antiplatelet use, which is required to prevent thromboembolic complications from the device...
November 14, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27814782/spanish-consensus-for-the-management-of-sinonasal-tumors
#17
Fernando López, Juan José Grau, José Antonio Medina, Isam Alobid
Sinonasal tumors are rare neoplasms with distinctive clinical, aetiological and pathological features. The diagnosis and treatment of these tumours is challenging because of their low incidence, histological diversity and production of non-specific symptoms in the early stages. They have a variable prognosis depending on their histology, origin and staging. Their location, close to neurocritical structures, which are of special relevance to surgery and postoperative treatment, makes their treatment difficult and complex, leading to high morbidity and mortality...
November 1, 2016: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/27781292/implementation-strategies-to-improve-knowledge-and-adherence-to-spinal-cord-injury-guidelines
#18
Staci Sue Reynolds, Laura L Murray, Susan M McLennon, Patricia R Ebright, Tamilyn Bakas
PURPOSE: The purpose of this study was to evaluate a bundle of implementation strategies (local opinion leaders, printed educational materials, and educational outreach) to increase neurocritical care nurses' knowledge of and adherence to spinal cord injury guidelines. DESIGN: A preprogram, postprogram, and follow-up design was used to evaluate outcomes. METHODS: Adherence was measured via self-reported anticipatory adherence; knowledge was measured by an author-developed assessment...
October 26, 2016: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
https://www.readbyqxmd.com/read/27776537/cerebrospinal-fluid-penetration-of-meropenem-in-neurocritical-care-patients-with-proven-or-suspected-ventriculitis-a-prospective-observational-study
#19
Ute Blassmann, Anka C Roehr, Otto R Frey, Cornelia Vetter-Kerkhoff, Niklas Thon, William Hope, Josef Briegel, Volker Huge
BACKGROUND: Ventriculitis is a complication of temporary intraventricular drains. The limited penetration of meropenem into the cerebrospinal fluid (CSF) is well known. However, ventricular CSF pharmacokinetic data in patients with ventriculitis are lacking. The aim of this study was to evaluate meropenem pharmacokinetics in the serum and CSF of neurocritical care patients with proven or suspected ventriculitis. METHODS: We conducted an observational pharmacokinetic study of neurocritical care patients with proven or suspected ventriculitis receiving meropenem...
October 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27770074/stable-incidence-but-declining-case-fatality-rates-of-subarachnoid-hemorrhage-in-a-population
#20
Jason Mackey, Jane C Khoury, Kathleen Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Opeolu Adeoye, Daniel Woo, Simona Ferioli, Felipe De Los Rios La Rosa, Sharyl Martini, Pooja Khatri, Joseph P Broderick, Mario Zuccarello, Dawn Kleindorfer
OBJECTIVE: To characterize temporal trends in subarachnoid hemorrhage (SAH) incidence and outcomes over 5 time periods in a large population-based stroke study in the United States. METHODS: All SAHs among residents of the Greater Cincinnati/Northern Kentucky region at least 20 years of age were identified and verified via study physician review in 5 distinct year-long study periods between 1988 and 2010. We abstracted demographics, care patterns, and outcomes, and we compared incidence and case-fatality rates across the study periods...
November 22, 2016: Neurology
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