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https://www.readbyqxmd.com/read/29318718/regional-cerebral-tissue-oxygen-saturation-changes-following-blood-transfusion-in-neuro-intensive-care-unit-patients%C3%A2-%C3%A2-a-pilot-observational-study
#1
R Muthuchellappan, N A Shaikh, R M Surve, U R S Ganne, M Philip
BACKGROUND: Although central venous oxygen saturation (ScvO2 ) is used to decide on red blood cell (RBC) transfusion, whether its improvement is associated with parallel improvement in cerebral oxygenation is not adequately studied. This study looked at changes in regional cerebral tissue oxygen saturation (rSO2 ) following RBC transfusion in neuro-intensive care unit (ICU) patients. METHODS: In this prospective observational pilot study, rSO2 was measured in adult neuro-ICU patients before RBC transfusion, at the end and at 6, 12, 18 and 24 h after RBC transfusion...
January 10, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29279639/posterior-reversible-leukoencephalopathy-syndrome-pres-in-intensive-care-unit-case-series
#2
Antara Gokhale, Atheel Kimona, Sandeep Kantor, S Prakash, Yogesh Manhas
Introduction: Posterior reversible encephalopathy syndrome (PRES) is characterized by a range of clinico neuro radiological manifestation along with hypertension due to varied etiology. Contrary to its name, a small number of patients have residual neurological deficits. Patients with severe manifestation of PRES may get admitted to the Intensive Care Unit (ICU) due to coma or status epilepticus. Small case series and large multicenter studies have been reported. Materials and Methods: We report a single center series of ten cases admitted to ICU over a 5 year period in a tertiary care centre...
November 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29163364/telomere-length-in-preterm-infants-a-promising-biomarker-of-early-adversity-and-care-in-the-neonatal-intensive-care-unit
#3
Livio Provenzi, Giunia Scotto di Minico, Roberto Giorda, Rosario Montirosso
Preterm infants present an immature neurobehavioral profile at birth, even in absence of severe brain injuries and perinatal complications. As such, they require a long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU), which is thought to grant at-risk newborns' survival, but still entails a number of physical, painful, and socio-emotional stressors. Hence, preterm birth and NICU stay represent an early adverse experience, which has been linked to detrimental consequences for neurological, neuro-endocrinal, behavioral, and socio-emotional development, as well as to disease later in life...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#4
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29108406/intracerebral-hemorrhage-in-intensive-care-unit-early-prognostication-fallacies-a-single-center-retrospective-study
#5
Stefano Spina, Chiara Marzorati, Alessia Vargiolu, Federico Magni, Matteo Riva, Matteo Rota, Carlo Giussani, Erik P Sganzerla, Giuseppe Citerio
BACKGROUND: Intracerebral hemorrhage (ICH) admitted to intensive care is deem of poor prognosis. To compare observed and predicted 30-days mortality and to evaluate long term functional outcome in a consecutive ICH cohort. METHODS: Retrospective analysis of prospectively collected data of ICH patients managed in a Neuro-ICU from 2012 to 2015. RESULTS: 136 consecutive patients; 34 (25%) had "withholding of life-sustaining treatment" (WLST) order and 102 (75%) received a "full treatment" (FT)...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29098494/toxicity-of-inhaled-agents-after-prolonged-administration
#6
Panumart Manatpon, W Andrew Kofke
Inhaled anesthetics have been utilized mostly for general anesthesia in the operating room and oftentimes for sedation and for treatment of refractory status epilepticus and status asthmaticus in the intensive care unit. These contexts in the ICU setting are related to potential for prolonged administration wherein potential organ toxicity is a concern. Over the last decade, several clinical and animal studies of neurotoxicity attributable to inhaled anesthetics have been emerging, particularly in extremes of age...
November 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29098418/bilateral-carotid-cavernous-sinus-fistula-a-case-report-and-review-of-the-literature
#7
REVIEW
Gavin Docherty, Maryam Eslami, Kailun Jiang, Jason S Barton
Carotid cavernous fistula (CCF) is an abnormal vascular shunt from the carotid artery to the cavernous sinus. They are commonly classified based on hemodynamics, etiology or anatomically. Hemodynamic classification refers to whether the fistula is high or low flow. Etiology is commonly secondary to trauma or can occur spontaneously in the setting of aneurysm or medical conditions predisposing to arterial wall defects. Bilateral carotid cavernous fistulas are rare. We present a case of bilateral CCF secondary to trauma...
November 2, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29075902/relation-of-gray-white-matter-ratio-with-long-term-cognitive-functions-and-quality-of-life-in-patients-with-mild-to-moderate-aneurysmal-subarachnoid-hemorrhage-a-prospective-observational-study
#8
Achmet Ali, Gamze Tanirgan, Pulat Akin Sabanci, Nukhet Sivrikoz, Taner Abdullah, Altay Sencer, Serra Sencer, Mukadder Orhan-Sungur, Ibrahim Ozkan Akinci
BACKGROUND: In the present study, we hypothesized that a low gray matter-white matter ratio (GWR) is associated with poor cognitive function and low quality of life in patients with mild to moderate (WFNS ≤3) aneurysmal subarachnoid hemorrhage (aSAH). METHODS: All patients with aSAH who were admitted to the neurointensive care unit (Neuro ICU) and whose WFNS score was ≤ 3 were enrolled in the study. During the Neuro ICU follow-up period, the following variables were recorded: demographics, neurological status, comorbidities, time elapsed between onset of bleeding and Neuro ICU admission, treatment method, number of days with vasospasm symptoms (DVS) and vasopressor usage...
January 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29074315/basal-cell-carcinoma-of-the-scalp-with-destruction-and-invasion-into-the-calvarium-and-dura-mater-report-of-7-cases-and-review-of-literature
#9
Churl-Su Kwon, Omar Al Awar, Valeria Ripa, Ghassan Said, Saulius Rocka
Basal cell carcinoma (BCC) is the most common skin malignancy in humans. Giant BCC is a rarer entity that is characterised by aggressive biological behaviour. Intracranial invasion by a BCC on the scalp is extremely rare. The gold standard treatment of BCCs is represented by surgical excision with a wide variety of reconstructive techniques. In this paper, we describe the largest series to date of recurrent BCCs with intracranial extension involving the dura mater. We report recurrent giant BCC of the scalp with dura mater invasion in 7 patients...
October 23, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28988019/acute-intermittent-porphyria-after-right-hemi-colectomy
#10
Shadi Alshammary, Reem Al Dulaijan, Khaldoon Saleh, Hazem Zakaria, Ahmed Eldamati, Norah Alwakeel, Abdulmohsen Al-Mulhim
INTRODUCTION: Acute intermittent porphyria is a rare autosomal dominant metabolic disease. It is caused by a genetic mutation that results in deficiency of porphobilinogen deaminase enzyme, the third enzyme in heme biosynthesis. Acute intermittent porphyria precipitated by surgery is very rare. CASE PRESENTATION: We present a 24 year-old woman who developed acute intermittent porphyria five days after right hemi-colectomy. Her presentation included neuro-visceral and psychiatric manifestations, and severe hyponatremia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28975076/comparing-the-effect-of-adaptive-support-ventilation-asv-and-synchronized-intermittent-mandatory-ventilation-simv-on-respiratory-parameters-in-neurosurgical-icu-patients
#11
Mohammadreza Ghodrati, Alireza Pournajafian, Ali Khatibi, Mohammad Niakan, Mohammad Hosein Hemadi, Mohammad Mahdi Zamani
BACKGROUND: Various modes of mechanical ventilation have different effects on respiratory variables. Lack of patients' neuro-ventilatory coordination and increasing the work of breathing are major disadvantages in mechanically ventilated patients. OBJECTIVES: This study is conducted to compare the respiratory parameters differences in Adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) modes in neurosurgical ICU patients...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28962816/shared-decision-making-in-neurocritical-care
#12
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...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28962814/nosocomial-infections-in-the-neurointensive-care-unit
#13
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...
November 2017: Neurologic Clinics
https://www.readbyqxmd.com/read/28933267/neonatal-plasticity-of-the-nociceptive-system-mechanisms-effects-and-treatment-of-repetitive-painful-procedures-during-nicu-admittance
#14
N J Van den Hoogen, J Patijn, D Tibboel, E A Joosten
INTRODUCTION: In Neonatal Intensive Care Unit (NICU), prematurely born infants undergo a range of skin breaking and painful procedures. At the same time, the spinal nociceptive system is in a sensitive developmental stage. Both neonatal repetitive painful procedures and their treatment can induce plasticity of the neonatal spinal nociceptive system, causing long-lasting alterations to pain processing and pain reactivity. METHODS: This review focuses on developmental processes related to the nociceptive network in the spinal dorsal horn and more specifically at mechanisms related to 1...
September 21, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#15
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28904458/can-transcranial-color-doppler-spectral-signatures-be-a-novel-biomarker-for-monitoring-cerebrovascular-autoregulation-and-intracranial-pressure-a-speculative-synthesis
#16
Sandhya Mangalore, Kotresh, Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
BACKGROUND: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). MATERIAL AND METHOD: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes...
July 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28894384/technology-that-achieves-the-triple-aim-an-economic-analysis-of-the-brainpath%C3%A2-approach-in-neurosurgery
#17
Sidney P Norton, Evan M Dickerson, Charles G Kulwin, Mitesh V Shah
BACKGROUND: The Triple Aim is defined as: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care. The purpose of this analysis was to evaluate the economic value of a new neurosurgical technique, the BrainPath™ approach, for use in patients with subcortical tumors and intracerebral hemorrhage (ICH). METHODS: Inpatient length of stay (LOS) data were collected for ICH and brain tumor surgical patient cases between August 2013 and November 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28797752/efficacy-of-continuous-positive-airway-pressure-and-incentive-spirometry-on-respiratory-functions-during-the-postoperative-period-following-supratentorial-craniotomy-a-prospective-randomized-controlled-study
#18
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28741102/the-range-of-neurological-complications-in-chikungunya-fever
#19
T Cerny, M Schwarz, U Schwarz, J Lemant, P Gérardin, E Keller
BACKGROUND: Chikungunya fever is a globally spreading mosquito-borne disease that shows an unexpected neurovirulence. Even though the neurological complications have been a major cause of intensive care unit admission and death, to date, there is no systematic analysis of their spectrum available. OBJECTIVE: To review evidence of neurological manifestations in Chikungunya fever and map their epidemiology, clinical spectrum, pathomechanisms, diagnostics, therapies and outcomes...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28721340/post-intensive-care-syndrome-an-overview
#20
Gautam Rawal, Sankalp Yadav, Raj Kumar
Survival of critically unwell patients has improved in the last decade due to advances in critical care medicine. Some of these survivors develop cognitive, psychiatric and /or physical disability after treatment in intensive care unit (ICU), which is now recognized as post intensive care syndrome (PICS). Given the limited awareness about PICS in the medical faculty this aspect is often overlooked which may lead to reduced quality of life and cause a lot of suffering of these patients and their families. Efforts should be directed towards preventing PICS by minimizing sedation and early mobilization during ICU...
June 2017: Journal of Translational Internal Medicine
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