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Neuro Intensive Care

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https://www.readbyqxmd.com/read/27907954/today-s-approach-to-treating-brain-swelling-in-the-neuro-intensive-care-unit
#1
Shreyansh Shah, W Taylor Kimberly
Brain swelling is an urgent clinical problem that frequently accompanies ischemic stroke, brain hemorrhage, and traumatic brain injury; it increases morbidity and mortality associated with them. It occurs due to failure of membrane transporters and leakage of the blood-brain barrier (BBB), resulting in combination of cytotoxic, ionic, and vasogenic edema. Currently, decompressive craniectomy and osmotherapy are the mainstays of management, but these therapies do not halt the underlying molecular cascade leading to brain swelling...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27856381/what-questionnaires-to-use-when-measuring-quality-of-life-in-sacral-tumor-patients-the-updated-sacral-tumor-survey
#2
Olivier D R van Wulfften Palthe, Stein J Janssen, Jay S Wunder, Peter C Ferguson, Guo Wei, Peter S Rose, Micheal J Yaszemski, Franklin H Sim, Patrick J Boland, John H Healey, Francis J Hornicek, Joseph H Schwab
BACKGROUND CONTEXT: Patient reported outcomes are becoming increasingly important when investigating results of patient and disease management. In sacral tumor patients symptoms can vary substantially, therefore no single questionnaire can adequately account for the full spectrum of symptoms and disability. PURPOSE: The purpose of this study is to analyze redundancy within the current sacral tumor survey and make a recommendation for an updated version based on the results and patient and expert opinions...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27833207/brain-death-and-true-patient-care
#3
Doyen Nguyen
The "brain death" standard as a criterion of death is closely associated with the need for transplantable organs from heart-beating donors. Are all of these potential donors really dead, or does the documented evidence of patients destined for organ harvesting who improve, or even recover to live normal lives, call into question the premise underlying "brain death"? The aim of this paper is to re-examine the notion of "brain death," especially its clinical test-criteria, in light of a broad framework, including medical knowledge in the field of neuro-intensive care and the traditional ethics of the medical profession...
August 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27789620/scalp-congenital-hemangioma-with-associated-high-output-cardiac-failure-in-a-premature-infant-case-report-and-review-of-literature
#4
Sumedh S Shah, Brian M Snelling, Samir Sur, Alexandra R Ramnath, Emmalee S Bandstra, Dileep R Yavagal
INTRODUCTION: Scalp congenital hemangiomas (CHs) are rare vascular malformations among infants; they can be associated with an array of complications, including cardiac and cosmetic issues. Here, we report the endovascular treatment of a premature infant with a suspected large right parietal scalp hemangioma and associated high-output cardiac failure. CASE DESCRIPTION: A two-day-old female premature infant (29 weeks gestational age; 1330 g birth weight) was referred by the neonatologists to our department for consultation and potential treatment of a large right parietal CH causing abrupt hypotension and high-output cardiac failure...
October 27, 2016: Interventional Neuroradiology
https://www.readbyqxmd.com/read/27771198/yield-of-repeated-intermittent-eeg-for-seizure-detection-in-critically-ill-adults
#5
Yannick Fogang, Benjamin Legros, Chantal Depondt, Nicolas Mavroudakis, Nicolas Gaspard
INTRODUCTION: Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. OBJECTIVES: To determine the yield of intermittent EEG (iEEG) to detect critically ill adult patients with seizures and to identify the factors that affect this yield. METHODS: We retrospectively analyzed cEEG data and medical records from 977 consecutive critically ill patients undergoing cEEG...
October 19, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27763820/is-there-hope-is-she-there-how-families-and-clinicians-experience-severe-acute-brain-injury
#6
Rachael E C Schutz, Heather L Coats, Ruth A Engelberg, J Randall Curtis, Claire J Creutzfeldt
BACKGROUND: Patients with severe acute brain injury (SABI) raise important palliative care considerations associated with sudden devastating injury and uncertain prognosis. OBJECTIVE: The goal of this study was to explore how family members, nurses, and physicians experience the palliative and supportive care needs of patients with SABI receiving care in the neuroscience intensive care unit (neuro-ICU). DESIGN: Semistructured interviews were audiotaped, transcribed, and analyzed using thematic analysis...
October 20, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27749460/utility-of-continuous-eeg-monitoring-in-noncritically-lll-hospitalized-patients
#7
Santoshi Billakota, Saurabh R Sinha
INTRODUCTION: Continuous EEG (cEEG) monitoring is used in the intensive care unit (ICU) setting to detect seizures, especially nonconvulsive seizures and status epilepticus. The utility and impact of such monitoring in non-ICU patients are largely unknown. METHODS: Hospitalized patients who were not in an ICU and underwent cEEG monitoring in the first half of 2011 and 2014 were identified. Reason for admission, admitting service (neurologic and nonneurologic), indication for cEEG, comorbid conditions, duration of recording, EEG findings, whether an event/seizure was recorded, and impact of EEG findings on management were reviewed...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27748789/implementation-of-a-proactive-nutrition-protocol-improves-enteral-nutrition-in-mechanically-ventilated-patients-admitted-to-the-neuro-intensive-care-unit
#8
Beatrice Cl Lim, Chin Ted Chong, Sean Lim
No abstract text is available yet for this article.
September 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27673345/early-physiotherapy-by-passive-range-of-motion-does-not-affect-partial-brain-tissue-oxygenation-in-neurocritical-care-patients
#9
Christian Roth, Hubertus Stitz, Jens Kleffmann, Stefanie Kaestner, Wolfgang Deinsberger, Andreas Ferbert, Markus Gehling
Background Studies investigating multimodal cerebral monitoring including partial brain tissue oxygen monitoring (ptiO2) in neuro-intensive care patients during physiotherapy are completely lacking in the literature. Materials and Methods We performed a post hoc analysis of prospectively collected data of patients on multimodal cerebral monitoring by intracranial pressure (ICP) and cerebral perfusion pressure (CPP) measurement as well as ptiO2. Patients with severe brain diseases were treated with passive range of motion (PROM)...
September 27, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27604350/utility-of-neuron-specific-enolase-in-traumatic-brain-injury-relations-to-s100b-levels-outcome-and-extracranial-injury-severity
#10
Eric Peter Thelin, Emma Jeppsson, Arvid Frostell, Mikael Svensson, Stefania Mondello, Bo-Michael Bellander, David W Nelson
BACKGROUND: In order to improve assessment and outcome prediction in patients suffering from traumatic brain injury (TBI), cerebral protein levels in serum have been suggested as biomarkers of injury. However, despite much investigation, biomarkers have yet to reach broad clinical utility in TBI. This study is a 9-year follow-up and clinical experience of the two most studied proteins, neuron-specific enolase (NSE) and S100B, in a neuro-intensive care TBI population. Our aims were to investigate to what extent NSE and S100B, independently and in combination, could predict outcome, assess injury severity, and to investigate if the biomarker levels were influenced by extracranial factors...
September 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27571205/variation-in-structure-and-process-of-care-in-traumatic-brain-injury-provider-profiles-of-european-neurotrauma-centers-participating-in-the-center-tbi-study
#11
Maryse C Cnossen, Suzanne Polinder, Hester F Lingsma, Andrew I R Maas, David Menon, Ewout W Steyerberg
INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
2016: PloS One
https://www.readbyqxmd.com/read/27546765/psychosocial-resiliency-is-associated-with-lower-emotional-distress-among-dyads-of-patients-and-their-informal-caregivers-in-the-neuroscience-intensive-care-unit
#12
Kelly M Shaffer, Eric Riklin, Jamie M Jacobs, Jonathan Rosand, Ana-Maria Vranceanu
PURPOSE: The purpose of the study is to examine the associations of patients' and their informal caregivers' psychosocial resiliency factors with their own and their partners' emotion domains (distress, anxiety, depression, and anger) after admission to the neuroscience intensive care unit (Neuro-ICU). MATERIALS AND METHODS: Eighty-three dyads of patients (total n = 87) and their informal caregivers (total n = 99) participated in this observational, cross-sectional study by self-reporting demographics and measures of resiliency factors (mindfulness [Cognitive and Affective Mindfulness Scale Revised], coping [Measure of Coping Status-A], intimate bond [Intimate Bond Measure], self-efficacy [patients: General Self-Efficacy Scale; caregivers: Revised Caregiver Self-Efficacy Scale]) and emotion domains (Emotion Thermometers) within 2 weeks of Neuro-ICU admission...
July 16, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27468506/-autonomic-nervous-system-and-its-imbalance-in-neuro-intensive-care-unit
#13
K A Popugaev, A Yu Lubnin, M V Zabelin, A S Samoylov
The autonomic nervous system (ANS) provides homeostasis due to the innervation of the secretory glands, smooth muscle and cardiac muscle. Higher centers of the ANS (primarily the hypothalamus, some centers of the brain stem and limbic system) form a integrative network, which plays a key role in coordinating the functioning of the endocrine, immune system and other parts of the central nervous system. Intracranial centers of the ANS are responsible for the consciousness, behavioral, emotional, and other components of the higher nervous activity...
March 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27404044/perioperative-predictors-of-extubation-failure-and-the-effect-on-clinical-outcome-after-infratentorial-craniotomy
#14
Ye-Hua Cai, Hai-Tang Wang, Jian-Xin Zhou
BACKGROUND The purpose of the study was to analyze the risk factors for failed extubation in subjects submitted to infratentorial craniotomy. MATERIAL AND METHODS Patients aged over 18 years who received infratentorial craniotomy for brain tumor resection were consecutively included in this study. Perioperative variables were collected and analyzed. Univariate analyses and multiple logistic regression were used to derive factors related to failed extubation. Patients had follow-up care until either out of hospital or death...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27364336/invasive-seizure-monitoring-in-the-critically-ill-brain-injury-patient-current-practices-and-a-review-of-the-literature
#15
REVIEW
Charles B Mikell, Timothy G Dyster, Jan Claassen
Seizures commonly occur in a variety of serious neurological illnesses, and lead to additional morbidity and worsened outcomes. Recently, it has become clear that not all seizures in the acute brain injury setting are evident on scalp EEG. To address this, we have developed a protocol for depth electrode placement in the neuro-intensive care unit for patients in whom the clinical suspicion of occult seizures is high. In the current manuscript, we review the literature on depth EEG monitoring for ictal events in critically-ill, unconscious patients, focusing on the incidence of seizures not detected with scalp EEG in various conditions...
October 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27356654/efficacy-and-safety-of-levetiracetam-in-the-management-of-seizures-in-neonates
#16
Mostafa Sedighi, Farzaneh Asadi, Nasrin Moradian, Mazyar Vakiliamini, Mohamad Moradian
OBJECTIVE: To evaluate the efficacy and safety of levetiracetam (LEV) in the management of seizures in neonates. METHODS: A prospective non-blind, single arm clinical trial conducted in the Department of Neonatology and Pediatric Intensive Care, Mohamad Kermanshahi, and Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran from May 2014 to December 2014. Fifty out of 60 newborns with gestational age >/=30 weeks with clinically diagnosed seizures were included...
July 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/27309999/antimicrobial-use-in-patients-on-a-comfort-care-protocol-a-retrospective-cohort-study
#17
Susan E Merel, Cynthia A Meier, Christy M McKinney, Paul S Pottinger
BACKGROUND: Antimicrobials are commonly used in patients near the end of life, but the percentage and predictors of patients prescribed antibiotics while hospitalized on a comfort care protocol are unknown. OBJECTIVE: To determine how often patients in the acute care setting are continued on antimicrobials when they are transitioned to comfort-focused care and to describe patient characteristics correlated with antimicrobial use. DESIGN: Retrospective cohort study conducted from June 2012 to August 2014...
November 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27271341/cerebral-function-monitoring-on-a-general-paediatric-ward-feasibility-and-potential
#18
Vivek Kalra, Shahul Sikkander Shaw, Stacey Dixon, Divyen K Shah, Paul Clarke
UNLABELLED: Cerebral function monitoring is widely used in neonatal intensive care, but its potential role in assessment of older infants is scarcely reported. We reviewed the use of cerebral function monitoring on a general paediatric ward in a series of young infants admitted with abnormal movements. Review of the amplitude-integrated EEG obtained by cerebral function monitoring revealed electrographic seizures in four of seven infants monitored. We also surveyed general paediatric wards in hospitals in our region of the UK to ask about current use of cerebral function monitoring and local availability of formal electroencephalography services...
August 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27270251/hour-25-neuro-icu
#19
Saurabh Sinha
This short story focuses on two patients in a neuro intensive care unit. (PsycINFO Database Record
June 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27256295/association-between-relative-anemia-and-early-functional-recovery-after-severe-traumatic-brain-injury-tbi
#20
Kevin R Carr, Michelle Rodriguez, Alex Ottesen, Joel Michalek, Colin Son, Vaibhav Patel, David Jimenez, Ali Seifi
BACKGROUND: Severe traumatic brain injury is associated with a multi-systemic response and changes in metabolic demand. Patients requiring intracranial pressure monitoring or cerebrospinal fluid diversion, often signifies a greater severity of injury. For this group, the association between RBC transfusion, transfusion thresholds, and clinical recovery is unknown. In this study, we studied the association between transfusion and clinical recovery for severe traumatic brain injury patients requiring external ventricular drain or intracranial pressure monitor placement...
October 2016: Neurocritical Care
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