keyword
https://read.qxmd.com/read/38478363/provider-experience-with-the-use-of-ketamine-for-refractory-status-epilepticus
#21
REVIEW
Gabriela Tantillo, Nicole Davis, Justin Granstein, Ji Yeoun Yoo, Parul Agarwal, Kaitlin Reilly, Alexandra Reynolds, Gina Kayal, John Liang, Nathalie Jetté
OBJECTIVE: Refractory status epilepticus (RSE) treated with anesthetic agents can be associated with complications including respiratory depression and hypotension. Ketamine is an emerging RSE treatment, but optimal dosing and timing are unknown. We studied provider attitudes and practices regarding the use of ketamine for RSE. METHODS: A literature review informed the creation of the survey, developed by professionals in epilepsy, pharmacy, and neurocritical care...
March 2024: Clinical Neuropharmacology
https://read.qxmd.com/read/38476193/derivation-and-validation-of-a-quantitative-risk-prediction-model-for-weaning-and-extubation-in-neurocritical-patients
#22
JOURNAL ARTICLE
Weiling Cheng, Ning Zhang, Dongcheng Liang, Haoling Zhang, Lei Wang, Leqing Lin
BACKGROUND: Patients with severe neurological conditions are at high risk during withdrawal and extubation, so it is important to establish a model that can quantitatively predict the risk of this procedure. METHODS: By analyzing the data of patients with traumatic brain injury and tracheal intubation in the ICU of the affiliated hospital of Hangzhou Normal University, a total of 200 patients were included, of which 140 were in the modeling group and 60 were in the validation group...
2024: Frontiers in Neurology
https://read.qxmd.com/read/38475798/long-term-outcome-in-new-onset-refractory-status-epilepticus-a-retrospective-study
#23
JOURNAL ARTICLE
Federica Stretti, Stefan Yu Bögli, Francesca Casagrande, Amanda Eisele, Marian Galovic, Emanuela Keller, Giovanna Brandi
BACKGROUND: New onset refractory status epilepticus (NORSE) is a neurologic emergency without an immediately identifiable cause. The complicated and long ICU stay of the patients can lead to perceiving a prolongation of therapies as futile. However, a recovery is possible even in severe cases. This retrospective study investigates ICU treatments, short- and long-term outcome and ethical decisions of a case series of patients with NORSE. METHODS: Overall, 283 adults were admitted with status epilepticus (SE) to the Neurocritical Care Unit of the University Hospital Zurich, Switzerland, between 01...
March 12, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38474990/time-series-modeling-and-forecasting-of-cerebral-pressure-flow-physiology-a-scoping-systematic-review-of-the-human-and-animal-literature
#24
REVIEW
Nuray Vakitbilir, Logan Froese, Alwyn Gomez, Amanjyot Singh Sainbhi, Kevin Y Stein, Abrar Islam, Tobias J G Bergmann, Izabella Marquez, Fiorella Amenta, Younis Ibrahim, Frederick A Zeiler
The modeling and forecasting of cerebral pressure-flow dynamics in the time-frequency domain have promising implications for veterinary and human life sciences research, enhancing clinical care by predicting cerebral blood flow (CBF)/perfusion, nutrient delivery, and intracranial pressure (ICP)/compliance behavior in advance. Despite its potential, the literature lacks coherence regarding the optimal model type, structure, data streams, and performance. This systematic scoping review comprehensively examines the current landscape of cerebral physiological time-series modeling and forecasting...
February 23, 2024: Sensors
https://read.qxmd.com/read/38471987/monitoring-of-cerebral-blood-flow-autoregulation-physiologic-basis-measurement-and-clinical-implications
#25
REVIEW
Eric L Vu, Charles H Brown, Kenneth M Brady, Charles W Hogue
Cerebral blood flow (CBF) autoregulation is the physiologic process whereby blood supply to the brain is kept constant over a range of cerebral perfusion pressures ensuring a constant supply of metabolic substrate. Clinical methods for monitoring CBF autoregulation were first developed for neurocritically ill patients and have been extended to surgical patients. These methods are based on measuring the relationship between cerebral perfusion pressure and surrogates of CBF or cerebral blood volume (CBV) at low frequencies (<0...
March 11, 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38466294/treatment-of-refractory-status-epilepticus-with-continuous-intravenous-anesthetic-drugs-a-systematic-review
#26
JOURNAL ARTICLE
Yu Kan Au, Mohammed F Kananeh, Rahul Rahangdale, Timothy Eoin Moore, Gregory A Panza, Nicolas Gaspard, Lawrence J Hirsch, Andres Fernandez, Syed Omar Shah
IMPORTANCE: Multiple continuous intravenous anesthetic drugs (CIVADs) are available for the treatment of refractory status epilepticus (RSE). There is a paucity of data comparing the different types of CIVADs used for RSE. OBJECTIVE: To systematically review and compare outcome measures associated with the initial CIVAD choice in RSE in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. EVIDENCE REVIEW: Data sources included English and non-English articles using Embase, MEDLINE, PubMed, and Web of Science (January 1994-June 2023) as well as manual search...
March 11, 2024: JAMA Neurology
https://read.qxmd.com/read/38464893/the-neurological-wake-up-test-in-severe-pediatric-traumatic-brain-injury-a-long-term-single-center-experience
#27
JOURNAL ARTICLE
Hilde D Mulder, Jelte Helfferich, Martin C J Kneyber
OBJECTIVES: To describe the use and outcomes of the neurological wake-up test (NWT) in pediatric severe traumatic brain injury (pTBI). DESIGN: Retrospective single-center observational cohort study. SETTING: Medical-surgical tertiary pediatric intensive care unit (PICU) in a university medical center and Level 1 Trauma Center. PATIENTS: Children younger than 18 years with severe TBI [i.e., Glasgow Coma Scale (GCS) of ≤8] admitted between January 2010 and December 2020...
2024: Frontiers in Pediatrics
https://read.qxmd.com/read/38450047/stressing-over-ulcer-prophylaxis-in-the-neurocritical-trauma-patient
#28
COMMENT
Gena V Topper, Purvi Pravinchandra Patel, Tanya Egodage
No abstract text is available yet for this article.
2024: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/38448744/noninvasive-assessment-of-intracranial-pressure-deformability-index-as-an-adjunct-to-optic-nerve-sheath-diameter-to-increase-diagnostic-ability
#29
JOURNAL ARTICLE
Dag Ferner Netteland, Mads Aarhus, Else Charlotte Sandset, Llewellyn Padayachy, Eirik Helseth, Reidar Brekken
BACKGROUND: Today, invasive intracranial pressure (ICP) measurement remains the standard, but its invasiveness limits availability. Here, we evaluate a novel ultrasound-based optic nerve sheath parameter called the deformability index (DI) and its ability to assess ICP noninvasively. Furthermore, we ask whether combining DI with optic nerve sheath diameter (ONSD), a more established parameter, results in increased diagnostic ability, as compared to using ONSD alone. METHODS: We prospectively included adult patients with traumatic brain injury with invasive ICP monitoring, which served as the reference measurement...
March 6, 2024: Neurocritical Care
https://read.qxmd.com/read/38447480/evaluating-the-utility-of-quantitative-pupillometry-in-a-neuro-critical-care-setting-for-the-monitoring-of-intracranial-pressure-a-prospective-cohort-study
#30
JOURNAL ARTICLE
Ahmad M S Ali, Wisha Gul, Jon Sen, Sarah-Jane Hewitt, Farouk Olubajo, Catherine McMahon
INTRODUCTION: Assessment of the pupillary light reflex (PLR) is key in intensive care monitoring of neurosurgical patients, particularly for monitoring intracranial pressure (ICP). Quantitative pupillometry using a handheld pupillometer is a reliable method for PLR assessment. However, many variables are derived from such devices. We therefore aimed to assess the performance of these variables at monitoring ICP. METHODS: Sedated patients admitted to neurocritical care in a tertiary neurosurgical centre with invasive ICP monitoring were included...
March 2, 2024: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/38443709/dose-dependent-tranexamic-acid-blunting-of-penumbral-leukocyte-mobilization-and-blood-brain-barrier-permeability-following-traumatic-brain-injury-an-in-vivo-murine-study
#31
JOURNAL ARTICLE
Matthew C Culkin, Priyanka Bele, Anastasia P Georges, Patricia Santos, Grace Niziolek, Lewis J Kaplan, Douglas H Smith, Jose L Pascual
BACKGROUND: Early posttraumatic brain injury (TBI) tranexamic acid (TXA) may reduce blood-brain barrier (BBB) permeability, but it is unclear if this effect is fixed regardless of dose. We hypothesized that post-TBI TXA demonstrates a dose-dependent reduction of in vivo penumbral leukocyte mobilization, BBB microvascular permeability, and enhancement of neuroclinical recovery. METHODS: CD1 male mice (n = 40) were randomly assigned to TBI by controlled cortical impact (injury [I]) or sham TBI (S), followed by intravenous bolus of either saline (placebo [P]) or TXA (15, 30, or 60 mg/kg)...
March 5, 2024: Neurocritical Care
https://read.qxmd.com/read/38443708/sovateltide-ilr-1620-improves-motor-function-and-reduces-hyperalgesia-in-a-rat-model-of-spinal-cord-injury
#32
JOURNAL ARTICLE
Theodoros Mavridis, Artemis Mavridi, Eleftheria Karampela, Antonis Galanos, George Gkiokas, Nicoletta Iacovidou, Theodoros Xanthos
BACKGROUND: Spinal cord injury (SCI) presents a major global health challenge, with rising incidence rates and substantial disability. Although progress has been made in understanding SCI's pathophysiology and early management, there is still a lack of effective treatments to mitigate long-term consequences. This study investigates the potential of sovateltide, a selective endothelin B receptor agonist, in improving clinical outcomes in an acute SCI rat model. METHODS: Thirty male Sprague-Dawley rats underwent sham surgery (group A) or SCI and treated with vehicle (group B) or sovateltide (group C)...
March 5, 2024: Neurocritical Care
https://read.qxmd.com/read/38436898/optimal-bispectral-index-exists-in-healthy-patients-undergoing-general-anesthesia-a-validation-study
#33
JOURNAL ARTICLE
Logan Froese, Alwyn Gomez, Amanjyot Singh Sainbhi, Nuray Vakitbilir, Izabella Marquez, Fiorella Amenta, Kangyun Park, Kevin Y Stein, Neil Berrington, Perry Dhaliwal, Frederick A Zeiler
PURPOSE: Continuous cerebrovascular reactivity monitoring in both neurocritical and intra-operative care has gained extensive interest in recent years, as it has documented associations with long-term outcomes (in neurocritical care populations) and cognitive outcomes (in operative cohorts). This has sparked further interest into the exploration and evaluation of methods to achieve an optimal cerebrovascular reactivity measure, where the individual patient is exposed to the lowest insult burden of impaired cerebrovascular reactivity...
March 4, 2024: Journal of Clinical Monitoring and Computing
https://read.qxmd.com/read/38435993/the-application-of-two-drainage-angles-in-neurocritical-care-patients-with-complicated-pneumonia-a-randomized-controlled-trial
#34
Anna Zhao, Huangrong Zeng, Hui Yin, Jinlin Wang, Wenming Yuan, Chao Li, Yan Zhong, Lanlan Ma, Chongmao Liao, Hong Zeng, Yan Li
BACKGROUND: Although head elevation is an early first-line treatment for elevated intracranial pressure (ICP), the use of the head-down or prone position in managing neurocritical patients is controversial because a change in a position directly affects the intracranial and cerebral perfusion pressure, which may cause secondary brain injury and affect patient outcomes. This study compared the effects of two postural drainage positions (30° head-up tilt and 0° head flat) on the prognosis of neurocritical care patients with complicated pneumonia and a clinical pulmonary infection score (CPIS) ≥5 points to provide a reference for selecting appropriate postural drainage positions for patients with pneumonia in neurocritical care units...
2024: PeerJ
https://read.qxmd.com/read/38431382/transcranial-sonography-in-the-critical-patient
#35
REVIEW
Juan Antonio Llompart-Pou, Laura Galarza, Rosario Amaya-Villar, Daniel Agustín Godoy
Transcranial ultrasonography is a non-invasive, bedside technique that has become a widely implemented tool in the evaluation and management of neurocritically ill patients. It constitutes a technique in continuous growth whose fundamentals (and limitations) must be known by the intensivist. This review provides a practical approach for the intensivist, including the different sonographic windows and planes of insonation and its role in different conditions of the neurocritical patients and in critical care patients of other etiologies...
March 2024: Medicina intensiva
https://read.qxmd.com/read/38429611/noninvasive-intracranial-pressure-monitoring-are-we-there-yet
#36
EDITORIAL
Venkatakrishna Rajajee
There is an urgent unmet need for a reliable noninvasive tool to detect elevations in intracranial pressure (ICP) above guideline-recommended thresholds for treatment. Gold standard invasive ICP monitoring is unavailable in many settings, including resource-limited environments, and in situations such as liver failure in which coagulopathy increases the risk of invasive monitoring. Although a large number of noninvasive techniques have been evaluated, this article reviews the potential clinical role, if any, of the techniques that have undergone the most extensive evaluation and are already in clinical use...
March 1, 2024: Neurocritical Care
https://read.qxmd.com/read/38429610/association-between-early-mobilization-and-functional-outcomes-in-patients-with-aneurysmal-subarachnoid-hemorrhage-a-multicenter-retrospective-propensity-score-matched-study
#37
JOURNAL ARTICLE
Hikaru Takara, Shota Suzuki, Shuhei Satoh, Yoko Abe, Shohei Miyazato, Yoshiki Kohatsu, Shin Minakata, Masamichi Moriya
BACKGROUND: Early mobilization has been shown to promote functional recovery and prevent complications in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, the efficacy of early mobilization in patients with aSAH remains unclear. This study aimed to investigate the association between early mobilization and functional outcomes in patients with aSAH. METHODS: This multicenter retrospective study was conducted in Japan and included patients with aSAH who received physical therapy with or without occupational therapy from April 2014 to March 2019...
March 1, 2024: Neurocritical Care
https://read.qxmd.com/read/38426178/editorial-neurosonology-in-stroke-medicine-and-neurocritical-care
#38
EDITORIAL
Stefano Caproni, Piergiorgio Lochner, Michele Romoli
No abstract text is available yet for this article.
2024: Frontiers in Neurology
https://read.qxmd.com/read/38424323/variations-in-autoregulation-based-optimal-cerebral-perfusion-pressure-determination-using-two-integrated-neuromonitoring-platforms-in-a-trauma-patient
#39
JOURNAL ARTICLE
Guillaume Plourde, François Martin Carrier, Philippe Bijlenga, Hervé Quintard
BACKGROUND: Neuromonitoring devices are often used in traumatic brain injury. The objective of this report is to raise awareness concerning variations in optimal cerebral perfusion pressure (CPPopt) determination using exploratory information provided by two neuromonitoring monitors that are part of research programs (Moberg CNS Monitor and RAUMED NeuroSmart LogO). METHODS: We connected both monitors simultaneously to a parenchymal intracranial pressure catheter and recorded the pressure reactivity index (PRx) and the derived CPPopt estimates for a patient with a severe traumatic brain injury...
February 29, 2024: Neurocritical Care
https://read.qxmd.com/read/38424037/diagnosis-and-management-of-subarachnoid-haemorrhage
#40
REVIEW
Suneesh Thilak, Poppy Brown, Tony Whitehouse, Nandan Gautam, Errin Lawrence, Zubair Ahmed, Tonny Veenith
Aneurysmal subarachnoid haemorrhage (aSAH) presents a challenge to clinicians because of its multisystem effects. Advancements in computed tomography (CT), endovascular treatments, and neurocritical care have contributed to declining mortality rates. The critical care of aSAH prioritises cerebral perfusion, early aneurysm securement, and the prevention of secondary brain injury and systemic complications. Early interventions to mitigate cardiopulmonary complications, dyselectrolytemia and treatment of culprit aneurysm require a multidisciplinary approach...
February 29, 2024: Nature Communications
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