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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
#1
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/29770889/autoregulation-in-the-neuro-icu
#2
REVIEW
Anson Wang, Santiago Ortega-Gutierrez, Nils H Petersen
PURPOSE OF REVIEW: The purpose of this review is to briefly describe the concept of cerebral autoregulation, to detail several bedside techniques for measuring and assessing autoregulation, and to outline the impact of impaired autoregulation on clinical and functional outcomes in acute brain injury. Furthermore, we will review several autoregulation studies in select forms of acute brain injuries, discuss the potential for its use in patient management in the ICU, and suggest further avenues for research...
May 17, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29770244/predicting-length-of-stay-in-intensive-care-units-after-cardiac-surgery-comparison-of-artificial-neural-networks-and-adaptive-neuro-fuzzy-system
#3
Hamidreza Maharlou, Sharareh R Niakan Kalhori, Shahrbanoo Shahbazi, Ramin Ravangard
Objectives: Accurate prediction of patients' length of stay is highly important. This study compared the performance of artificial neural network and adaptive neuro-fuzzy system algorithms to predict patients' length of stay in intensive care units (ICU) after cardiac surgery. Methods: A cross-sectional, analytical, and applied study was conducted. The required data were collected from 311 cardiac patients admitted to intensive care units after surgery at three hospitals of Shiraz, Iran, through a non-random convenience sampling method during the second quarter of 2016...
April 2018: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29752016/perioperative-research-into-memory-prime-cognitive-impairment-following-a-severe-burn-injury-and-critical-care-admission-part-1
#4
Edward J R Watson, Klará Nenadlová, Olivia H Clancy, Mena Farag, Naz A Nordin, Agnes Nilsen, Ashley R T Mehmet, Ahmed Al-Hindawi, Sundhiya Mandalia, Lisa M Williams, Trudi L Edginton, Marcela P Vizcaychipi
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks...
May 8, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#5
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29713575/an-evaluation-of-complications-in-femoral-arterial-sheaths-maintained-post-neuroangiographic-procedures
#6
Zalan Khan, Premkumar Nattanamai, Premkumar Keerthivaas, Christopher R Newey
BACKGROUND: Digital subtraction angiography (DSA) is a frequently used technique in the neuro-diagnosis and treatment of cerebrovascular diseases. The routine use of femoral arterial sheaths (FAS) peri-procedurally has become standard. The maintenance of a FAS post-procedure may be warranted while awaiting the normalization of coagulopathy or to reaccess emergently. We retrospectively reviewed our stroke dataset to evaluate for complications associated with the prolonged use of FAS post-procedure...
February 26, 2018: Curēus
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#7
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29648985/feasibility-of-telemetric-intracranial-pressure-monitoring-in-the-neuro-intensive-care-unit
#8
Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
May 3, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29580936/safety-and-feasibility-of-a-neuroscience-critical-care-program-to-mobilize-patients-with-primary-intracerebral-hemorrhage
#9
Mona N Bahouth, Melinda C Power, Elizabeth K Zink, Kate Kozeniewski, Sowmya Kumble, Sandra Deluzio, Victor C Urrutia, Robert D Stevens
OBJECTIVE: To measure the impact of a progressive mobility program on patients admitted to a neuroscience critical care unit (NCCU) with intracerebral hemorrhage (ICH). The early mobilization of critically ill patients with spontaneous ICH is a challenge due to the potential for neurologic deterioration and hemodynamic lability in the acute phase of injury. Patients admitted to the ICU have been excluded from randomized trials of early mobilization after stroke. DESIGN: An interdisciplinary working group developed a formalized NCCU Mobility Algorithm which allocates patients to incremental passive or active mobilization pathways on the basis of level of consciousness and motor function...
March 23, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#10
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29574442/development-of-the-combined-assessment-of-risk-encountered-in-surgery-cares-surgical-risk-calculator-for-prediction-of-postsurgical-mortality-and-need-for-intensive-care-unit-admission-risk-a-single-center-retrospective-study
#11
Diana Xin Hui Chan, Yilin Eileen Sim, Yiong Huak Chan, Ruban Poopalalingam, Hairil Rizal Abdullah
INTRODUCTION: Accurate surgical risk prediction is paramount in clinical shared decision making. Existing risk calculators have limited value in local practice due to lack of validation, complexities and inclusion of non-routine variables. OBJECTIVE: We aim to develop a simple, locally derived and validated surgical risk calculator predicting 30-day postsurgical mortality and need for intensive care unit (ICU) stay (>24 hours) based on routinely collected preoperative variables...
March 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29549820/resiliency-is-independently-associated-with-greater-quality-of-life-among-informal-caregivers-to-neuroscience-intensive-care-unit-patients
#12
Emily L Zale, Tessa J Heinhuis, Tara Tehan, Danielle Salgueiro, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS: Informal caregivers (N = 79, Mage  = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization...
May 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29502720/shared-decision-making-in-neurocritical-care
#13
REVIEW
Muhammad Waqas Khan, Susanne Muehlschlegel
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit...
April 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29502719/nosocomial-infections-in-the-neurointensive-care-unit
#14
REVIEW
Katharina Maria Busl
Infectious complications in the neurointensive care unit (neuro-ICU) are common, including pneumonia, urinary tract infection, bloodstream infection, and intracranial infection. The neuro-ICU population poses a specific challenge in the diagnosis of infections, because of the high incidence of fever in acutely brain-injured patients. Furthermore, susceptibility to infections is likely enhanced by brain-injury (induced immune modulation). This article reviews the concept of brain injury-induced immune modulation, and summarizes available data and knowledge on nosocomial meningitis and ventriculitis, and systemic infectious complications in patients with traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and status epilepticus...
April 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29492562/investigation-of-the-relationship-between-the-burden-of-raised-icp-and-the-length-of-stay-in-a-neuro-intensive-care-unit
#15
Martin Shaw, Laura Moss, Chris Hawthorne, John Kinsella, Ian Piper
OBJECTIVES: Raised intracranial pressure (ICP) is well known to be indicative of a poor outcome in traumatic brain injury (TBI). This phenomenon was quantified using a pressure time index (PTI) model of raised ICP burden in a paediatric population. Using the PTI methodology, this pilot study is aimed at investigating the relationship between raised ICP and length of stay (LOS) in adults admitted to a neurological intensive care unit (neuro-ICU). MATERIALS AND METHODS: In 10 patients admitted to the neuro-ICU following TBI, ICP was measured and data from the first 24 h were analysed...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29492556/a-waveform-archiving-system-for-the-ge-solar-8000i-bedside-monitor
#16
Andrea Fanelli, Rohan Jaishankar, Aristotelis Filippidis, James Holsapple, Thomas Heldt
OBJECTIVES:  Our objective was to develop, deploy, and test a data-acquisition system for the reliable and robust archiving of high-resolution physiological waveform data from a variety of bedside monitoring devices, including the GE Solar 8000i patient monitor, and for the logging of ancillary clinical and demographic information. MATERIALS AND METHODS:  The data-acquisition system consists of a computer-based archiving unit and a GE Tram Rac 4A that connects to the GE Solar 8000i monitor...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29462714/alterations-of-conjunctival-glycocalyx-and-microcirculation-in-non-septic-critically-ill-patients
#17
Andrius Pranskunas, Tomas Tamosuitis, Neringa Balciuniene, Diana Damanskyte, Edvin Sneider, Astra Vitkauskiene, Edmundas Sirvinskas, Vidas Pilvinis, E Christiaan Boerma
As of now the relationship between glycocalyx degradation and microcirculatory perfusion abnormalities in non-septic critical ill patients is unclear. In addition, conjunctival sidestream dark field-imaging for the purpose of glycocalyx thickness estimation has never been performed. We aimed to investigate whether changes in glycocalyx thickness in non-septic patients are associated with microcirculatory alterations in conjunctival and sublingual mucosa. In this single-centre prospective observational study, using techniques for direct in-vivo observation of the microcirculation, we performed a single measurement of microcirculatory perfusion parameters and visualized glycocalyx thickness in both ocular conjunctiva and sublingual mucosa in mixed cardio surgical (n = 18) and neurocritical patients (n = 27) and compared these data with age-matched healthy controls (n = 20)...
July 2018: Microvascular Research
https://www.readbyqxmd.com/read/29422735/successful-use-of-ketamine-for-burst-suppression-in-super-refractory-status-epilepticus-following-substance-abuse
#18
Dnyaneshwar P Mutkule, S Manimala Rao, Jaydip Ray Chaudhuri, Kunche Rajasri
Status epilepticus is frequently encountered in neuro Intensive Care Units. It is a medical emergency and if not treated promptly can lead to severe brain damage and even death. Here, we present the case of a 18-year-old male with uncontrolled and unrelenting seizures with a rare etiology requiring ketamine infusion for burst suppression as it was resistant to thiopentone and midazolam infusions. The management of this case is presented in detail.
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29415773/end-expiratory-occlusion-maneuver-to-predict-fluid-responsiveness-in-the-intensive-care-unit-an-echocardiographic-study
#19
Delphine Georges, Hugues de Courson, Romain Lanchon, Musa Sesay, Karine Nouette-Gaulain, Matthieu Biais
BACKGROUND: In mechanically ventilated patients, an increase in cardiac index during an end-expiratory-occlusion test predicts fluid responsiveness. To identify this rapid increase in cardiac index, continuous and instantaneous cardiac index monitoring is necessary, decreasing its feasibility at the bedside. Our study was designed to investigate whether changes in velocity time integral and in peak velocity obtained using transthoracic echocardiography during an end-expiratory-occlusion maneuver could predict fluid responsiveness...
February 8, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29413730/healthcare-associated-ventriculitis-and-meningitis-in-a-neuro-icu-incidence-and-risk-factors-selected-by-machine-learning-approach
#20
Ivan Savin, Ksenia Ershova, Nataliya Kurdyumova, Olga Ershova, Oleg Khomenko, Gleb Danilov, Michael Shifrin, Vladimir Zelman
PURPOSE: To define the incidence of healthcare-associated ventriculitis and meningitis (HAVM) in the neuro-ICU and to identify HAVM risk factors using tree-based machine learning (ML) algorithms. METHODS: An observational cohort study was conducted in Russia from 2010 to 2017, and included high-risk neuro-ICU patients. We utilized relative risk analysis, regressions, and ML to identify factors associated with HAVM development. RESULTS: 2286 patients of all ages were included, 216 of them had HAVM...
February 5, 2018: Journal of Critical Care
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