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https://www.readbyqxmd.com/read/29434566/assessment-of-platelet-function-in-traumatic-brain-injury-a-retrospective-observational-study-in-the-neuro-critical-care-setting
#1
Caroline Lindblad, Eric Peter Thelin, Michael Nekludov, Arvid Frostell, David W Nelson, Mikael Svensson, Bo-Michael Bellander
Background: Despite seemingly functional coagulation, hemorrhagic lesion progression is a common and devastating condition following traumatic brain injury (TBI), stressing the need for new diagnostic techniques. Multiple electrode aggregometry (MEA) measures platelet function and could aid in coagulopathy assessment following TBI. The aims of this study were to evaluate MEA temporal dynamics, influence of concomitant therapy, and its capabilities to predict lesion progression and clinical outcome in a TBI cohort...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29388863/saved-by-the-pupillometer-a-role-for-pupillometry-in-the-acute-assessment-of-patients-with-traumatic-brain-injuries
#2
John A Emelifeonwu, Kirsten Reid, Jonathan Kj Rhodes, Lynn Myles
There is good evidence that pupil reactivity is useful for prognostication in acute head injuries. Despite this, most pupil assessments are subjective and are performed by physicians who may not be experts. They can therefore be unreliable. We present a case of a patient with seemingly irreversible demise from an acute traumatic subdural haematoma. This was determined by assessment of his pupils, which were non-reactive to light at the time of arrival to the neurosurgical theatre. He was transferred to the neurointensive care for brainstem death testing, where assessment by objective pupillometry determined that his pupils were in fact reactive...
February 1, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29368635/cerebral-metabolic-effects-of-strict-versus-conventional-glycaemic-targets-following-severe-traumatic-brain-injury
#3
Mark P Plummer, Natalia Notkina, Ivan Timofeev, Peter J Hutchinson, Mark E Finnis, Arun K Gupta
BACKGROUND: Optimal glycaemic targets for patients with severe traumatic brain injury remain unclear. The primary objective of this microdialysis study was to compare cerebral metabolism with strict versus conventional glycaemic control. METHODS: We performed a prospective single-centre randomised controlled within-subject crossover study of 20 adult patients admitted to an academic neurointensive care unit with severe traumatic brain injury. Patients underwent randomised, consecutive 24-h periods of strict (4-7 mmol/L; 72-126 mg/dl) and conventional (<10 mmol/L; 180 mg/dl) glycaemic control with microdialysis measurements performed hourly...
January 25, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29362771/orpheus-descent-into-the-neurointensive-care-unit
#4
Francesco Brigo
No abstract text is available yet for this article.
January 23, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29234973/decompressive-craniectomy-in-traumatic-brain-injury-usage-and-clinical-outcome-in-a-single-centre
#5
Teodor Svedung Wettervik, Samuel Lenell, Lena Nyholm, Tim Howells, Anders Lewén, Per Enblad
BACKGROUND: Two randomised controlled trials (RCTs) of decompressive craniectomy (DC) in traumatic brain injury (TBI) have shown poor outcome, but there are considerations of how these protocols relate to real practice. The aims of this study were to evaluate usage and outcome of DC and thiopental in a single centre. METHOD: The study included all TBI patients treated at the neurointensive care unit, Akademiska sjukhuset, Uppsala, Sweden, between 2008 and 2014. Of 609 patients aged 16 years or older, 35 treated with DC and 23 treated with thiopental only were studied in particular...
December 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29218511/optical-monitoring-of-cerebral-microcirculation-in-neurointensive-care
#6
Peter Rejmstad, Neda Haj-Hosseini, Oscar Åneman, Karin Wårdell
Continuous optical monitoring of local cerebral microcirculation could benefit neurointensive care patients treated for subarachnoid hemorrhage (SAH). The aim of the study was to evaluate laser Doppler flowmetry (LDF) and diffuse reflectance spectroscopy (DRS) for long-term monitoring of brain microcirculation and oxygen saturation (SO2) in the neurointensive care unit (NICU). A fiber optic probe was designed for intraparenchymal use and connected to LDF and DRS for assessment of the local blood flow (perfusion and tissue reflectance (TLI)) and SO2 in the brain...
December 8, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29203481/concentrations-of-cefuroxime-in-brain-tissue-of-neurointensive-care-patients
#7
A Hosmann, L C Ritscher, H Burgmann, Z Oesterreicher, W Jäger, S Poschner, E Knosp, A Reinprecht, A Gruber, M Zeitlinger
Introduction Effective concentrations of antibiotics in brain tissue are essential for antimicrobial therapy of brain infections. However, data concerning cerebral penetration properties of antibiotics for treatment or prophylaxis of central nervous system infections are rare.Methods Six patients suffering subarachnoid hemorrhage and requiring cerebral microdialysis for neurochemical monitoring were included in this study. Free interstitial concentrations of cefuroxime after intravenous application of 1500 mg were measured by microdialysis in brain tissue as well as in plasma at steady-state (n=6) or after single-dose administration (n=1)...
December 4, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29180981/cerebral-microdialysis-monitoring-to-improve-individualized-neurointensive-care-therapy-an-update-of-recent-clinical-data
#8
REVIEW
Laurent Carteron, Pierre Bouzat, Mauro Oddo
Cerebral microdialysis (CMD) allows bedside semicontinuous monitoring of patient brain extracellular fluid. Clinical indications of CMD monitoring are focused on the management of secondary cerebral and systemic insults in acute brain injury (ABI) patients [mainly, traumatic brain injury (TBI), subarachnoid hemorrhage, and intracerebral hemorrhage (ICH)], specifically to tailor several routine interventions-such as optimization of cerebral perfusion pressure, blood transfusion, glycemic control and oxygen therapy-in the individual patient...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29177800/-neurointensive-care-medicine-from-where-where-to
#9
EDITORIAL
W Stummer, S Schwab, G R Fink
No abstract text is available yet for this article.
November 24, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/29102527/functional-assessment-of-a-series-of-paediatric-patients-receiving-neurointensive-treatment-new-functional-status-scale
#10
P Madurga-Revilla, J López-Pisón, P Samper-Villagrasa, R Garcés-Gómez, J P García-Íñiguez, M Domínguez-Cajal, I Gil-Hernández, S Viscor-Zárate
INTRODUCTION: Functional health, a reliable parameter of the impact of disease, should be used systematically to assess prognosis in paediatric intensive care units (PICU). Developing scales for the assessment of functional health is therefore essential. The Paediatric Overall and Cerebral Performance Category (POPC, PCPC) scales have traditionally been used in paediatric studies. The new Functional Status Scale (FSS) was designed to provide more objective results. This study aims to confirm the validity of the FSS compared to the classic POPC and PCPC scales, and to evaluate whether it may also be superior to the latter in assessing of neurological function...
November 1, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29099419/acute-systemic-complications-of-convulsive-status-epilepticus-a-systematic-review
#11
REVIEW
Raoul Sutter, Tolga Dittrich, Saskia Semmlack, Stephan Rüegg, Stephan Marsch, Peter W Kaplan
OBJECTIVES: Status epilepticus is a neurologic emergency with high morbidity and mortality requiring neurointensive care and treatment of systemic complications. This systematic review compiles the current literature on acute systemic complications of generalized convulsive status epilepticus in adults and their immediate clinical impact along with recommendations for optimal neurointensive care. DATA SOURCES: We searched PubMed, Medline, Embase, and the Cochrane library for articles published between 1960 and 2016 and reporting on systemic complications of convulsive status epilepticus...
January 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29088962/complications-of-invasive-intracranial-pressure-monitoring-devices-in-neurocritical-care
#12
Samon Tavakoli, Geoffrey Peitz, William Ares, Shaheryar Hafeez, Ramesh Grandhi
Intracranial pressure monitoring devices have become the standard of care for the management of patients with pathologies associated with intracranial hypertension. Given the importance of invasive intracranial monitoring devices in the modern neurointensive care setting, gaining a thorough understanding of the potential complications related to device placement-and misplacement-is crucial. The increased prevalence of intracranial pressure monitoring as a management tool for neurosurgical patients has led to the publication of a plethora of papers regarding their indications and complications...
November 2017: Neurosurgical Focus
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
#13
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/29063262/-neurointensive-care-in-germany-results-of-an-inspection-of-intensive-care-units
#14
O Busse, S Hillmann, M Grond
BACKGROUND: The situation of neurointensive care in Germany is unclear. OBJECTIVES: An inspection of neurointensive wards should help to clarify the situation. MATERIALS AND METHODS: On the occasion of stroke unit certification audits, 320 intensive care units (39 independent neurological and 20 neurosurgical, 6 combined neurological/neurosurgical, 253 interdisciplinary intensive wards) were inspected. RESULTS: On the 39 neurological and the 20 neurosurgical intensive care units, a physician with intensive care specialization was available in 92% and 100% of units, respectively, and a physician with authorization for intensive care training was available in 74% and 80% of units, respectively...
February 2018: Der Nervenarzt
https://www.readbyqxmd.com/read/28980699/mobilization-in-early-rehabilitation-in-intensive-care-unit-patients-with-severe-acquired-cerebral-injury-an-observational-study
#15
Michelangelo Bartolo, Stefano Bargellesi, Carlo Alberto Castioni, Domenico Intiso, Andrea Fontana, Massimiliano Copetti, Federico Scarponi, Donatella Bonaiuti
OBJECTIVE: To determine whether early mobilization of patients with severe acquired brain injury, performed in the intensive/neurointensive care unit, influences functional outcome. DESIGN: Prospective observational study. SETTING: Fourteen centres in Italy. SUBJECTS: A total of 103 consecutive patients with acquired brain injury. METHODS: Clinical, neurological and functional data, including the Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), the Rancho Los Amigos Levels of Cognitive Functioning (LCF), Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome Scale (GOS), and Functional Independence Measure (FIM) were collected at admission and every 3?5 days until discharge from the intensive/neurointensive care unit...
October 5, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28962814/nosocomial-infections-in-the-neurointensive-care-unit
#16
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/28936494/detection-of-intracranial-hypertension-using-deep-learning
#17
Benjamin Quachtran, Robert Hamilton, Fabien Scalzo
Intracranial Hypertension, a disorder characterized by elevated pressure in the brain, is typically monitored in neurointensive care and diagnosed only after elevation has occurred. This reaction-based method of treatment leaves patients at higher risk of additional complications in case of misdetection. The detection of intracranial hypertension has been the subject of many recent studies in an attempt to accurately characterize the causes of hypertension, specifically examining waveform morphology. We investigate the use of Deep Learning, a hierarchical form of machine learning, to model the relationship between hypertension and waveform morphology, giving us the ability to accurately detect presence hypertension...
December 2016: Proceedings of the ... IAPR International Conference on Pattern Recognition
https://www.readbyqxmd.com/read/28929392/preventing-early-bouncebacks-to-the-neurointensive-care-unit-a-retrospective-analysis-and-quality-improvement-pilot
#18
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/28904572/outcome-predictors-in-pediatric-head-trauma-a-study-of-clinicoradiological-factors
#19
Kanwaljeet Garg, Ravi Sharma, Deepak Gupta, Sumit Sinha, Guru Dutt Satyarthee, Deepak Agarwal, Shashank Sarad Kale, Bhawani Shankar Sharma, Ashok Kumar Mahapatra
INTRODUCTION: Traumatic injuries are the leading cause of death and a major cause of disability among children. About 70%-80% of the accidental deaths in pediatric age group result directly from central nervous system lesions. METHODS: The purpose of our study was to study all the patients of ≤18 years of age with head or spinal injury admitted in neurointensive care unit at our center, an apex trauma center in a developing country, between June 2009 and September 2011...
April 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28885463/author-response-implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-ventriculostomies
#20
Megan T Moyer
No abstract text is available yet for this article.
October 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
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