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https://www.readbyqxmd.com/read/28713493/a-new-strategy-in-neurocritical-care-nurse-continuing-stroke-education-a-hybrid-simulation-pilot-study
#1
Christopher Ryan Newey, Robert Bell, Melody Burks, Premkumar Nattanmai
INTRODUCTION: High-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation - a combination of lecture and high-fidelity manikin - in the education of neurosciences nurses, involved in care of neurocritical care patients. METHODS: Neurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28685395/what-families-need-and-physicians-deliver-contrasting-communication-preferences-between-surrogate-decision-makers-and-physicians-during-outcome-prognostication-in-critically-ill-tbi-patients
#2
Thomas Quinn, Jesse Moskowitz, Muhammad W Khan, Lori Shutter, Robert Goldberg, Nananda Col, Kathleen M Mazor, Susanne Muehlschlegel
BACKGROUND: Surrogate decision-makers ("surrogates") and physicians of incapacitated patients have different views of prognosis and how it should be communicated, but this has not been investigated in neurocritically ill patients. We examined surrogates' communication preferences and physicians' practices during the outcome prognostication for critically ill traumatic brain injury (ciTBI) patients in two level-1 trauma centers and seven academic medical centers in the USA. METHODS: We used qualitative content analysis and descriptive statistics of transcribed interviews to identify themes in surrogates (n = 16) and physicians (n = 20)...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28685393/side-effects-of-long-term-continuous-intra-arterial-nimodipine-infusion-in-patients-with-severe-refractory-cerebral-vasospasm-after-subarachnoid-hemorrhage
#3
Martin Kieninger, Julia Flessa, Nicole Lindenberg, Sylvia Bele, Andreas Redel, André Schneiker, Gerhard Schuierer, Christina Wendl, Bernhard Graf, Vera Silbereisen
BACKGROUND: Long-term continuous intra-arterial nimodipine infusion (CIAN) is a rescue therapy option in cases of severe refractory cerebral vasospasm (CV) following acute non-traumatic subarachnoid hemorrhage (SAH). However, CIAN therapy can be associated with relevant side effects. Available studies focus on intracerebral complications, whereas extracerebral side effects are rarely examined. Aim of the present study was to generate descriptive data on the clinical course during CIAN therapy and expectable extracerebral side effects...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28675112/the-relationship-of-paranasal-sinus-opacification-to-hospital-acquired-pneumonia-in-the-neurologic-intensive-care-unit-patient
#4
Phillip Huyett, Nicholas R Rowan, Berrylin J Ferguson, Stella Lee, Eric W Wang
BACKGROUND: The association between intensive care unit (ICU) sinusitis and the development of lower airway infections remains unclear. The objective of this study was to determine the correlation between the development of radiographic sinus opacification and pneumonia in the neurologic ICU setting. METHODS: A retrospective review of head computed tomography or magnetic resonance imaging of 612 patients admitted to the neurocritical care unit at a tertiary care center from April 2013 through April 2014 was performed...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28675111/outcomes-of-tracheostomy-with-concomitant-and-delayed-percutaneous-endoscopic-gastrostomy-in-the-neuroscience-critical-care-unit
#5
Christa O'Hana S Nobleza, Vinciya Pandian, Ravirasmi Jasti, David H Wu, Marek A Mirski, Romergryko G Geocadin
BACKGROUND: In patients with severe neurologic conditions, percutaneous endoscopic gastrostomy (PEG) is typically performed either alone or with a tracheostomy. The characteristics and outcomes of patients receiving PEG concomitantly with a tracheostomy (CTPEG) and those receiving delayed PEG (DPEG) after a tracheostomy were compared. METHODS: Retrospective cohort study in a 24-bed neuroscience critical care unit (NCCU) at a tertiary care hospital. Consecutive patients admitted to the NCCU from April 2007 to July 2013 who underwent percutaneous tracheostomy and gastrostomy by the percutaneous tracheostomy team were included and grouped according to the timing of PEG placement: CTPEG versus DPEG...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28674514/aspects-on-the-physiological-and-biochemical-foundations-of-neurocritical-care
#6
REVIEW
Carl-Henrik Nordström, Lars-Owe Koskinen, Magnus Olivecrona
Neurocritical care (NCC) is a branch of intensive care medicine characterized by specific physiological and biochemical monitoring techniques necessary for identifying cerebral adverse events and for evaluating specific therapies. Information is primarily obtained from physiological variables related to intracranial pressure (ICP) and cerebral blood flow (CBF) and from physiological and biochemical variables related to cerebral energy metabolism. Non-surgical therapies developed for treating increased ICP are based on knowledge regarding transport of water across the intact and injured blood-brain barrier (BBB) and the regulation of CBF...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28665866/intracranial-aneurysms-of-neuro-ophthalmologic-relevance
#7
Jonathan A Micieli, Nancy J Newman, Daniel L Barrow, Valérie Biousse
BACKGROUND: Intracranial saccular aneurysms are acquired lesions that often present with neuro-ophthalmologic symptoms and signs. Recent advances in neurosurgical techniques, endovascular treatments, and neurocritical care have improved the optimal management of symptomatic unruptured aneurysms, but whether the chosen treatment has an impact on neuro-ophthalmologic outcomes remains debated. EVIDENCE ACQUISITION: A review of the literature focused on neuro-ophthalmic manifestations and treatment of intracranial aneurysms with specific relevance to neuro-ophthalmologic outcomes was conducted using Ovid MEDLINE and EMBASE databases...
June 29, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28661946/correlations-between-hourly-pupillometer-readings-and-intracranial-pressure-values
#8
Molly McNett, Cristina Moran, Clare Janki, Anastasia Gianakis
INTRODUCTION: Automated pupillometry is emerging as a mainstay in neurocritical care primarily because it overcomes limitations of manual pupillary examinations. Although several recent studies show improved assessment accuracy with a pupillometer, few investigate clinical use, specifically how well parameters correlate with multimodality monitoring and outcomes. The primary aim of this study was to examine correlations between serial pupillometer readings and intracranial pressure (ICP) values among neurocritically ill patients...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28660340/electroencephalographic-patterns-in-neurocritical-care-pathologic-contributors-or-epiphenomena
#9
Brian Appavu, James J Riviello
No abstract text is available yet for this article.
June 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28651504/critical-care-management-of-aneurysmal-subarachnoid-haemorrhage-in-australia-and-new-zealand-what-are-we-doing-and-where-to-from-here
#10
Andrew A Udy, Sacha Schweikert, James Anstey, Matthew Anstey, Jeremy Cohen, Oliver Flower, Edward Saxby, Andrew van der Poll, Anthony Delaney
Patients with an aneurysmal subarachnoid haemorrhage (SAH) frequently require admission to the intensive care unit. There, a variety of therapeutic strategies are initiated, in addition to definitive procedures aimed at securing the aneurysm. Despite a substantial investment in caring for these patients, outcomes for this group remain poor. Although the severity of the initial bleed is crucial in this context, many patients undergo further deterioration in the ICU. Delayed cerebral ischaemia is a significant cause of longterm morbidity and mortality after SAH...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28646445/update-on-neurocritical-care-of-stroke
#11
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
#12
Thomas Godet, Russell Chabanne, Jean-Michel Constantin
No abstract text is available yet for this article.
August 2017: Anesthesiology
https://www.readbyqxmd.com/read/28639000/infections-in-neurocritical-care
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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