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https://www.readbyqxmd.com/read/29933010/therapeutic-strategies-to-target-acute-and-long-term-sequelae-of-pediatric-traumatic-brain-injury
#1
REVIEW
Jimmy W Huh, Ramesh Raghupathi
Pediatric traumatic brain injury (TBI) remains one of the leading causes of morbidity and mortality in children. Experimental and clinical studies demonstrate that the developmental age, the type of injury (diffuse vs. focal) and sex may play important roles in the response of the developing brain to a traumatic injury. Advancements in acute neurosurgical interventions and neurocritical care have improved and led to a decrease in mortality rates over the past decades. However, survivors are left with life-long behavioral deficits underscoring the need to better define the cellular mechanisms underlying these functional changes...
June 19, 2018: Neuropharmacology
https://www.readbyqxmd.com/read/29912100/big-data-for-a-big-problem-precision-medicine-of-stroke-in-neurocritical-care
#2
David S Liebeskind
No abstract text is available yet for this article.
July 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29906310/a-randomized-pharmacokinetic-and-pharmacodynamic-evaluation-of-every-8-hour-and-12-hour-dosing-strategies-of-vancomycin-and-cefepime-in-neurocritically-ill-patients
#3
Lynn E Kassel, Edward T Van Matre, Charles J Foster, Douglas N Fish, Scott W Mueller, Deb S Sherman, Michael F Wempe, Robert MacLaren, Robert T Neumann, Tyree H Kiser
PURPOSE: Neurocritically-ill patients have clinically significant alterations in pharmacokinetic parameters of renally-eliminated medications, which may result in subtherapeutic plasma and cerebrospinal fluid antibiotic concentrations. METHODS: Prospective, randomized, open-label study of adult neurocritically-ill patients treated with vancomycin and cefepime. Vancomycin 15 mg/kg and cefepime 2 g were dosed at every 8 or 12-hour intervals. The primary outcomes were the achievement of pharmacodynamic targets related to time of unbound drug above minimum inhibitory concentrations (MIC) for 60% or more of the dosing interval (fT>MIC ≥60%) for β-lactams and ratio of 24-hour area under the curve (AUC):MIC of 400 or greater for vancomycin...
June 15, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29905509/the-siludrain-trial-a-prospective-randomized-controlled-trial-comparing-standard-versus-silver-impregnated-lumbar-drains
#4
Martin Jakobs, Sabrina Klein, Tatjana Eigenbrod, Andreas W Unterberg, Oliver W Sakowitz
OBJECTIVE Catheter-associated cerebrospinal fluid (CSF) infection remains a serious event, especially for patients in neurocritical care units. The use of external ventricular drain (EVD) catheters impregnated with antimicrobial substances has led to a significant reduction of infection rates. This study was undertaken to compare the use of antimicrobial, silver-impregnated external lumbar drains (si-ELDs) and conventional ELDs. METHODS Patients with an indication for ELD placement were randomized to receive either a conventional or an si-ELD catheter...
June 15, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29891575/education-research-variation-in-priorities-for-neurocritical-care-education-expressed-across-role-groups
#5
Abigail S Cohen, Saef Izzy, Monisha A Kumar, Cara J Joyce, Stephen A Figueroa, Matthew B Maas, Christiana E Hall, David L McDonagh, David P Lerner, Paul M Vespa, Lori A Shutter, Eric S Rosenthal
OBJECTIVE: To define expectations for neurocritical care (NCC) core competencies vs competencies considered within the domain of other subspecialists. METHODS: An electronic survey was disseminated nationally to NCC nurses, physicians, fellows, and neurology residents through Accreditation Council for Graduate Medical Education neurology residency program directors, United Council for Neurologic Subspecialties neurocritical care fellowship program directors, and members of the Neurocritical Care Society...
June 12, 2018: Neurology
https://www.readbyqxmd.com/read/29889725/introduction-of-continuous-video-eeg-monitoring-into-2-different-nicu-models-by-training-neonatal-nurses
#6
Ipsita Goswami, Luis Bello-Espinosa, Jeffrey Buchhalter, Harish Amin, Alexandra Howlett, Michael Esser, Sumesh Thomas, Cathy Metcalfe, Jan Lind, Norma Oliver, Silvia Kozlik, Khorshid Mohammad
BACKGROUND: Continuous video electroencephalographic (EEG) (cvEEG) monitoring is emerging as the standard of care for diagnosis and management of neonatal seizures. However, cvEEG is labor-intensive and the need to initiate and interpret studies on a 24-hour basis is a major limitation. PURPOSE: This study aims at establishing consistency in monitoring of newborns admitted to 2 different neonatal intensive care units (NICUs) managed by the same neurocritical care team...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29887294/controversies-in-weaning-from-mechanical-ventilation-and-extubation-in-the-neurocritical-patient
#7
M Jibaja, J L Sufan, D A Godoy
No abstract text is available yet for this article.
June 7, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29886041/outcomes-after-acute-symptomatic-seizures-in-children-admitted-to-a-neonatal-neurocritical-care-service
#8
Hannah C Glass, Adam L Numis, Dawn Gano, Varun Bali, Elizabeth E Rogers
BACKGROUND: Neonatal seizures due to acute brain injury are associated with high rates of death, disability, and epilepsy. Our objective was to examine incidence of and risk factors for epilepsy among survivors of acute symptomatic neonatal seizures who were cared for by a neonatal neurocritical care service. METHODS: Neonates with acute symptomatic seizures who were admitted to UCSF Benioff Children's Hospital Neuro-Intensive Care Nursery from July 2008 to June 2014 were considered for inclusion...
April 20, 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29875116/evidence-based-review-of-clinical-trials-in-neurocritical-care
#9
Molly McNett, Cristina Moran, Halee Johnson
Neurocritical care is a rapidly growing specialty of complex care for the critically ill patient with neurological injury. This rapid growth has led to an increase in the number of important clinical trials to guide clinical practice and evidence-based care of the critically ill patient with neurological injury. Specialty-trained critical care nurses and advanced practice providers are integral members of neurocritical care teams and must remain informed about pivotal trials shaping practice recommendations...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875115/multimodal-neuromonitoring-in-neurocritical-care
#10
Sarah H Peacock, Amanda D Tomlinson
Neuromonitoring is important for patients with acute brain injury. The bedside neurologic examination is standard for neurologic monitoring; however, a clinical examination may not reliably detect subtle changes in intracranial physiology. Changes found during neurologic examinations are often late signs. The assessment of multiple physiological variables in real time can provide new clinical insights into treatment decisions. No single monitoring modality is ideal for all patients. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism, such as in multimodal monitoring, allows an innovative approach to individualized patient care...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29875111/neurocritical-care-the-continued-evolution
#11
Diane C McLaughlin
No abstract text is available yet for this article.
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29865897/incidence-and-impact-of-withdrawal-of-life-sustaining-therapies-in-clinical-trials-of-severe-traumatic-brain-injury-a-systematic-review
#12
Guillaume Leblanc, Amélie Boutin, Michèle Shemilt, François Lauzier, Lynne Moore, Véronique Potvin, Ryan Zarychanski, Patrick Archambault, François Lamontagne, Caroline Léger, Alexis F Turgeon
Background Most deaths following severe traumatic brain injury follow decisions to withdraw life-sustaining therapies. However, the incidence of the withdrawal of life-sustaining therapies and its potential impact on research data interpretation have been poorly characterized. The aim of this systematic review was to assess the reporting and the impact of withdrawal of life-sustaining therapies in randomized clinical trials of patients with severe traumatic brain injury. Methods We searched Medline, Embase, Cochrane Central, BIOSIS, and CINAHL databases and references of included trials...
June 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29850022/heat-stroke
#13
REVIEW
Toru Hifumi, Yutaka Kondo, Keiki Shimizu, Yasufumi Miyake
Background: Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Thus, in this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29805825/ct-perfusion-to-guide-placement-of-invasive-cerebral-perfusion-monitor-in-subarachnoid-hemorrhage-induced-vasospasm
#14
Hosam Al-Jehani, Judith Marcoux, Kawthar Hadhiah, Faisal Alabbas, Mark Angle, Jeanne Teitelbaum
Background: Vasospasm is a challenging component of the subarachnoid hemorrhage "syndrome" that is unpredictable and very difficult to monitor using noninvasive or invasive monitoring technologies in neurocritical units. Methods: We describe the novel use of computerized tomography perfusion (CTP) imaging to choose proper targets for invasive cerebral blood flow monitors. Results: A total of 3 patients are included in this report...
2018: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29801883/novel-minimally-invasive-multi-modality-monitoring-modalities-in-neurocritical-care
#15
REVIEW
Fawaz Al-Mufti, Brendan Smith, Megan Lander, Nitesh Damodara, Rolla Nuoman, Mohammad El-Ghanem, Naveed Kamal, Sarmad Al-Marsoummi, Basim Alzubaidi, Halla Nuoaman, Brandon Foreman, Krishna Amuluru, Chirag D Gandhi
Elevated intracranial pressure (ICP) following brain injury contributes to poor outcomes for patients, primarily by reducing the caliber of cerebral vasculature, and thereby reducing cerebral blood flow. Careful monitoring of ICP is critical in these patients in order to determine prognosis, implement treatment when ICP becomes elevated, and to judge responsiveness to treatment. Currently, the gold standard for monitoring is invasive pressure transducers, usually an intraventricular monitor, which presents significant risk of infection and hemorrhage...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29799079/forewarning-of-hypotensive-events-using-a-bayesian-artificial-neural-network-in-neurocritical-care
#16
Rob Donald, Tim Howells, Ian Piper, P Enblad, P Nilsson, I Chambers, B Gregson, G Citerio, K Kiening, J Neumann, A Ragauskas, J Sahuquillo, R Sinnott, A Stell
Traumatically brain injured (TBI) patients are at risk from secondary insults. Arterial hypotension, critically low blood pressure, is one of the most dangerous secondary insults and is related to poor outcome in patients. The overall aim of this study was to get proof of the concept that advanced statistical techniques (machine learning) are methods that are able to provide early warning of impending hypotensive events before they occur during neuro-critical care. A Bayesian artificial neural network (BANN) model predicting episodes of hypotension was developed using data from 104 patients selected from the BrainIT multi-center database...
May 24, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29782388/glasgow-coma-scale-score-fluctuations-are-inversely-associated-with-a-nirs-based-index-of-cerebral-autoregulation-in-acutely-comatose-patients
#17
Ryan J Healy, Andres Zorrilla-Vaca, Wendy Ziai, Marek A Mirski, Charles W Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Lucia Rivera-Lara
BACKGROUND: The Glasgow Coma Scale (GCS) is an essential coma scale in critical care for determining the neurological status of patients and for estimating their long-term prognosis. Similarly, cerebral autoregulation (CA) monitoring has shown to be an accurate technique for predicting clinical outcomes. However, little is known about the relationship between CA measurements and GCS scores among neurological critically ill patients. This study aimed to explore the association between noninvasive CA multimodal monitoring measurements and GCS scores...
May 18, 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#18
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#19
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29732476/critical-thresholds-for-intracranial-pressure-vary-over-time-in-non-craniectomised-traumatic-brain-injury-patients
#20
Basil Nourallah, Frederick A Zeiler, Leanne Calviello, Peter Smielewski, Marek Czosnyka, David K Menon
BACKGROUND: Intracranial pressure (ICP)- and cerebral perfusion pressure (CPP)-guided therapy is central to neurocritical care for traumatic brain injury (TBI) patients. We sought to identify time-dependent critical thresholds for mortality and unfavourable outcome for ICP and CPP in non-craniectomised TBI patients. METHODS: This is a retrospective cohort study of 355 patients with moderate-to-severe TBI who received ICP monitoring and were managed without decompressive craniectomy in a tertiary hospital neurocritical care unit...
May 7, 2018: Acta Neurochirurgica
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