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https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#1
Jason Siegel, Michael A Pizzi, J Brent Peel, David Alejos, Nnenne Mbabuike, Benjamin L Brown, David Hodge, W David Freeman
PURPOSE OF REVIEW: This review will highlight the recent advancements in acute ischemic stroke diagnosis and treatment, with special attention to new features and recommendations of stroke care in the neurocritical care unit. RECENT FINDINGS: New studies suggest that pre-hospital treatment of stroke with mobile stroke units and telestroke technology may lead to earlier stroke therapy with intravenous tissue plasminogen activator (tPA), and recent studies show tPA can be given in previously contraindicated situations...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28640018/decision-to-extubate-brain-injured-patients-limiting-uncertainty-in-neurocritical-care
#2
Thomas Godet, Russell Chabanne, Jean-Michel Constantin
No abstract text is available yet for this article.
June 21, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28639000/infections-in-neurocritical-care
#3
John C O'Horo, Priya Sampathkumar
Neurointensive care (NICU) patients experience complex infectious disease challenges. Central nervous system (CNS) infections are difficult to diagnose and treat, and post-neurosurgical patients are vulnerable to a unique set of healthcare-acquired infections (HAI) in addition to those typical of critically ill patients. The purpose of this review is to summarize the approach to suspected infection in the NICU and discuss management of several infectious syndromes in the NICU setting.
June 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#4
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28622134/review-of-neurocritical-care-second-edition-edited-by-eelco-f-m-wijdicks-alejandro-a-rabinstein-sara-e-hocker-and-jennifer-e-fugate
#5
Petra N Davidson
No abstract text is available yet for this article.
2017: Neurodiagnostic Journal
https://www.readbyqxmd.com/read/28602751/time-of-elevation-of-head-of-bed-for-patients-receiving-mechanical-ventilation-and-its-related-factors
#6
L Martí-Hereu, A Arreciado Marañón
INTRODUCTION: The semirecumbent position is a widespread recommendation for the prevention of pneumonia associated with mechanical ventilation. AIMS: To identify the time of elevation of head of bed for patients under mechanical ventilation and the factors related to such elevation in an intensive care unit. MATERIALS AND METHODS: An observational, descriptive cross-sectional study. Conducted in an intensive care unit of a tertiary hospital from April to June 2015...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28595555/microdialysis-assessed-adipose-tissue-metabolism-in-critically-ill-patients
#7
Ioannis Ilias, Nikitas Nikitas, Maria Theodorakopoulou, Ioanna Dimopoulou
BACKGROUND: Microdialysis is a minimally invasive technique that allows direct in situ and in vivo sampling, studies and manipulations of the interstitial/extracellular fluid/space. It has been shown to be of use mainly in acute brain injury/neurocritical care. METHODS: Microdialysis has been used to study obesity, diabetes mellitus, inflammation and pharmacokinetics at the adipose tissue level. In critically ill patients (and particularly in those with sepsis or septic shock), within days to weeks, adipose tissue shows profound alterations; under such conditions the implementation of microdialysis can provide researchers with interesting findings...
June 8, 2017: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
https://www.readbyqxmd.com/read/28594285/cognitive-event-related-potentials-during-the-sub-acute-phase-of-severe-traumatic-brain-injury-and-their-relationship-to-outcome
#8
Solveig L Hauger, Kjell Olafsen, Caroline Schnakers, Nada Andelic, Kristian Bernhard Nilsen, Eirik Helseth, Ingrid Funderud, Stein Andersson, Anne-Kristine Schanke, Marianne Løvstad
Predicting outcome in the early phase after severe traumatic brain injury (sTBI) is a major clinical challenge, particularly identifying patients with potential of good cognitive outcome. The current single center prospective study aimed to explore presence and normalization of electroencephalography (EEG)-based event related potentials (ERPs) in the early phase following sTBI, and their relationship to functional and cognitive outcome 6 months post-injury. Fourteen adult patients with sTBI were recruited from the neurointensive care unit (mean age=38...
June 8, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28583451/assessment-of-cost-drivers-in-transsphenoidal-approaches-for-resection-of-pituitary-tumors-using-the-value-driven-outcome-database
#9
Michael Karsy, Andrea A Brock, Jian Guan, Erica F Bisson, William T Couldwell
INTRODUCTION: Reducing healthcare costs while improving quality of care has become imperative in neurosurgical care. The Value-Driven Outcome (VDO) database at the University of Utah is one approach that identifies cost drivers and tracks changes over time. METHODS: A retrospective review by was performed for transsphenoidal resections of pituitary adenomas from July 2012 to September 2016. Total cost, subcategory costs, and potential cost drivers were evaluated...
June 2, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28578113/safety-of-percutaneous-dilatational-tracheostomy-in-patients-with-acute-brain-injury-and-a-reduced-pao2-fio2-ratio-a-retrospective-analysis-of-54-patients
#10
Claudia Ditz, Jann F Wojak, Emma Smith, Abdulkareem Abusamha, Volker M Tronnier, Jan Gliemroth, Jan N Kuechler
OBJECTIVE: Percutaneous Dilatational Tracheostomy (PDT) is a commonly performed method in neurocritical care, whose safety has been proven in numerous studies. Nevertheless, there are poor data regarding the application in patients with acute brain injury and poor respiratory function. The purpose of this study was to evaluate the incidence of hypoxemia and hypercapnia during PDT in those patients. METHODS: In a retrospective analysis, we acquired data from 54 patients with an acute brain injury (ABI) and a reduced PaO2/FiO2 ratio (PaO2/FiO2<300mmHg)...
May 31, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28570328/liver-disease-and-neurology
#11
Robert N Schwendimann, Alireza Minagar
PURPOSE OF REVIEW: Neurologists often encounter patients with acute and chronic liver disease and must be aware of how these diseases can affect the nervous system. This is particularly true when evaluating patients with alterations in cognition and level of consciousness. Wilson disease, while uncommon, is a treatable condition with many neurologic and psychiatric symptoms. Neurologic disorders associated with liver disease may affect not only the brain, but also the spinal cord and peripheral nervous system...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28555777/early-ictal-and-interictal-patterns-in-fires-the-sparks-before-the-blaze
#12
Raquel Farias-Moeller, Luca Bartolini, Katelyn Staso, John M Schreiber, Jessica L Carpenter
OBJECTIVE: Febrile infection-related epilepsy syndrome (FIRES) is a catastrophic epileptic encephalopathy described as explosive onset of super refractory status epilepticus (SRSE) in previously healthy children. We describe electroencephalography (EEG) abnormalities in the hyperacute phase of FIRES, with the aim of contributing to the diagnostic characterization of a syndrome otherwise lacking specific biomarkers. METHODS: This is a retrospective single-center, case series of seven children with FIRES...
May 26, 2017: Epilepsia
https://www.readbyqxmd.com/read/28555164/brain-multimodality-monitoring-a-new-tool-in-neurocritical-care-of-comatose-patients
#13
REVIEW
Nudrat Tasneem, Edgar A Samaniego, Connie Pieper, Enrique C Leira, Harold P Adams, David Hasan, Santiago Ortega-Gutierrez
Neurocritical care patients are at risk of developing secondary brain injury from inflammation, ischemia, and edema that follows the primary insult. Recognizing clinical deterioration due to secondary injury is frequently challenging in comatose patients. Multimodality monitoring (MMM) encompasses various tools to monitor cerebral metabolism, perfusion, and oxygenation aimed at detecting these changes to help modify therapies before irreversible injury sets in. These tools include intracranial pressure (ICP) monitors, transcranial Doppler (TCD), Hemedex™ (thermal diffusion probe used to measure regional cerebral blood flow), microdialysis catheter (used to measure cerebral metabolism), Licox™ (probe used to measure regional brain tissue oxygen tension), and continuous electroencephalography...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/28547318/a-systematic-review-of-alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients
#14
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane W English
The use of sedative medications is commonplace in intensive care units (ICUs) and an invaluable clinical tool for the intensive care physician. Sedation for critically ill, mechanically ventilated patients provides an opportunity to reduce anxiety, discomfort as well as ventilator intolerance and dyssynchrony. Alpha-2 agonists in particular have become increasingly popular for use in the neurocritical care population due to their proposed effectiveness in facilitating examinations and procedures as well as reducing the need for adjunctive agents...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28545954/prognostic-role-of-copeptin-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis-of-observational-studies
#15
Kyu-Sun Choi, Youngsuk Cho, Bo-Hyoung Jang, Wonhee Kim, Chiwon Ahn, Tae Ho Lim, Hyoung-Joong Yi
PURPOSE: Copeptin, the C-terminal portion of provasopressin, has emerged as a novel prognostic marker in neurocritical care, such as in traumatic brain injury (TBI). The aim of this study was to quantitatively assess the prognostic significance of initial plasma copeptin levels in the neurological outcome and mortality after traumatic brain injury. MATERIALS AND METHODS: Six relevant studies with data from 552 patients were included in this meta-analysis. RESULTS: The plasma copeptin levels were found to be significantly higher in patients who died than in the survivors (standardized mean difference [SMD], 1...
April 19, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28543565/lactate-supplementation-in-severe-traumatic-brain-injured-adults-by-primed-constant-infusion-of-sodium-l-lactate
#16
Stephanie M Wolahan, Howard C Mao, Courtney Real, Paul M Vespa, Thomas C Glenn
Carbohydrate fuel augmentation following traumatic brain injury may be a viable treatment to improve recovery when cerebral oxidative metabolism of glucose is depressed. We performed a primed constant sodium L-lactate infusion in 11 moderate to severely brain injured adults. Blood was collected before and periodically during the infusion study. We quantified global cerebral uptake of glucose and lactate and other systemic metabolites associated with energy metabolism. Our hypothesis was that cerebral lactate uptake, as measured by the arteriovenous difference of lactate (AVDlac), would increase in severely injured TBI patients in the neurocritical care unit...
May 20, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#17
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28523595/announcing-current-concepts-exploring-what-is-new-provocative-and-controversial-in-neurocritical-care
#18
EDITORIAL
Stephan A Mayer
No abstract text is available yet for this article.
June 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28504980/hyperchloremia-is-associated-with-acute-kidney-injury-in-patients-with-subarachnoid-hemorrhage
#19
Ofer Sadan, Kai Singbartl, Prem A Kandiah, Kathleen S Martin, Owen B Samuels
OBJECTIVE: To assess the prevalence of acute kidney injury in patients with subarachnoid hemorrhage patients. DESIGN: Retrospective analysis of all subarachnoid hemorrhage admissions. SETTINGS: Neurocritical care unit. PATIENTS: All patients with a diagnosis of subarachnoid hemorrhage between 2009 and 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 1,267 patients included in this cohort, 16...
May 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28497668/potential-brain-dead-organ-donation-in-neurocritical-care-mortality
#20
Vera Spatenkova, Ondrej Bradac, Petr Suchomel
BACKGROUND: Mortality is a marker of quality in neurocritical care, but it also provides potential for donors after brain death (DBD) following irreversible acute brain damage. The aim of this study was to analyse the neurointensive care unit (NICU) mortality rate and recovery of potential DBD. METHODS: We performed a 10-year prospective observational cohort computer database analysis of 6138 acute neurological and neurosurgical patients (pts, 58.2% male, mean: age 55...
May 11, 2017: Journal of Neurosurgical Sciences
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