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Neuro Intensive Care

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https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#1
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29770244/predicting-length-of-stay-in-intensive-care-units-after-cardiac-surgery-comparison-of-artificial-neural-networks-and-adaptive-neuro-fuzzy-system
#2
Hamidreza Maharlou, Sharareh R Niakan Kalhori, Shahrbanoo Shahbazi, Ramin Ravangard
Objectives: Accurate prediction of patients' length of stay is highly important. This study compared the performance of artificial neural network and adaptive neuro-fuzzy system algorithms to predict patients' length of stay in intensive care units (ICU) after cardiac surgery. Methods: A cross-sectional, analytical, and applied study was conducted. The required data were collected from 311 cardiac patients admitted to intensive care units after surgery at three hospitals of Shiraz, Iran, through a non-random convenience sampling method during the second quarter of 2016...
April 2018: Healthcare Informatics Research
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#3
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29713575/an-evaluation-of-complications-in-femoral-arterial-sheaths-maintained-post-neuroangiographic-procedures
#4
Zalan Khan, Premkumar Nattanamai, Premkumar Keerthivaas, Christopher R Newey
BACKGROUND: Digital subtraction angiography (DSA) is a frequently used technique in the neuro-diagnosis and treatment of cerebrovascular diseases. The routine use of femoral arterial sheaths (FAS) peri-procedurally has become standard. The maintenance of a FAS post-procedure may be warranted while awaiting the normalization of coagulopathy or to reaccess emergently. We retrospectively reviewed our stroke dataset to evaluate for complications associated with the prolonged use of FAS post-procedure...
February 26, 2018: Curēus
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#5
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29670654/toxicities-associated-with-cisplatin-based-chemotherapy-and-radiotherapy-in-long-term-testicular-cancer-survivors
#6
REVIEW
Chunkit Fung, Paul Dinh, Shirin Ardeshir-Rouhani-Fard, Kerry Schaffer, Sophie D Fossa, Lois B Travis
Testicular cancer has become the paradigm of adult-onset cancer survivorship, due to the young age at diagnosis and 10-year relative survival of 95%. This clinical review presents the current status of various treatment-related complications experienced by long-term testicular cancer survivors (TCS) free of disease for 5 or more years after primary treatment. Cardiovascular disease and second malignant neoplasms represent the most common potentially life-threatening late effects. Other long-term adverse outcomes include neuro- and ototoxicity, pulmonary complications, nephrotoxicity, hypogonadism, infertility, and avascular necrosis...
2018: Advances in Urology
https://www.readbyqxmd.com/read/29648985/feasibility-of-telemetric-intracranial-pressure-monitoring-in-the-neuro-intensive-care-unit
#7
Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
May 3, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29589380/massage-reflexology-and-other-manual-methods-for-pain-management-in-labour
#8
REVIEW
Caroline A Smith, Kate M Levett, Carmel T Collins, Hannah G Dahlen, Carolyn C Ee, Machiko Suganuma
BACKGROUND: Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012. OBJECTIVES: To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour...
March 28, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29578831/is-it-feasible-and-safe-to-wake-cardiac-arrest-patients-receiving-mild-therapeutic-hypothermia-after-12-hours-to-enable-early-neuro-prognostication-the-therapeutic-hypothermia-and-early-waking-trial-protocol
#9
Noel Watson, Matt Potter, Grigoris Karamasis, Max Damian, Richard Pottinger, Gerald Clesham, Reto Gamma, Rajesh Aggarwal, Jeremy Sayer, Nicholas Robinson, Rohan Jagathesan, Alamgir Kabir, Kare Tang, Paul Kelly, Maria Maccaroni, Ramabhadran Kadayam, Raghu Nalgirkar, Gyanesh Namjoshi, Sali Urovi, Anirudda Pai, Kunal Waghmare, Vincenzo Caruso, James Hampton-Till, Marko Noc, John R Davies, Thomas R Keeble
Mild therapeutic hypothermia (MTH 33°C) post out-of-hospital cardiac arrest (OHCA) is widely accepted as standard of care. However, uncertainty remains around the dose and therapy duration. OHCA patients are usually kept sedated±paralyzed and ventilated for the first 24-36 hours, which allows for targeted temperature management, but makes neurological prognostication challenging. The aim of this study is to investigate the feasibility and safety of assessing the unconscious OHCA patient after 12 hours for early waking/extubation while continuing to provide MTH for 24 hours, and fever prevention for 72 hours by using an intravenous temperature management (IVTM) system and established conscious MTH anti-shiver regimens...
March 26, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29574442/development-of-the-combined-assessment-of-risk-encountered-in-surgery-cares-surgical-risk-calculator-for-prediction-of-postsurgical-mortality-and-need-for-intensive-care-unit-admission-risk-a-single-center-retrospective-study
#10
Diana Xin Hui Chan, Yilin Eileen Sim, Yiong Huak Chan, Ruban Poopalalingam, Hairil Rizal Abdullah
INTRODUCTION: Accurate surgical risk prediction is paramount in clinical shared decision making. Existing risk calculators have limited value in local practice due to lack of validation, complexities and inclusion of non-routine variables. OBJECTIVE: We aim to develop a simple, locally derived and validated surgical risk calculator predicting 30-day postsurgical mortality and need for intensive care unit (ICU) stay (>24 hours) based on routinely collected preoperative variables...
March 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29562556/how-does-strength-training-and-balance-training-affect-gait-and-fatigue-in-patients-with-multiple-sclerosis-a-study-protocol-of-a-randomized-controlled-trial
#11
Jacob Callesen, Davide Cattaneo, John Brincks, Ulrik Dalgas
INTRODUCTION: Multiple sclerosis (MS) is characterized by a demyelination that results in reduced conductivity in the somatosensory nervous system, decreased muscle strength, vestibular alteration, and severe fatigue. Progressive resistance training (PRT) has proven to be a promising intervention showing a positive effect on muscle strength. Another promising intervention frequently used in neuro-rehabilitation is task specific training where also Balance and Motor Control Training (BMCT) are incorporated...
2018: NeuroRehabilitation
https://www.readbyqxmd.com/read/29549820/resiliency-is-independently-associated-with-greater-quality-of-life-among-informal-caregivers-to-neuroscience-intensive-care-unit-patients
#12
Emily L Zale, Tessa J Heinhuis, Tara Tehan, Danielle Salgueiro, Jonathan Rosand, Ana-Maria Vranceanu
OBJECTIVE: Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS: Informal caregivers (N = 79, Mage  = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization...
May 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29502720/shared-decision-making-in-neurocritical-care
#13
REVIEW
Muhammad Waqas Khan, Susanne Muehlschlegel
Shared decision making is a collaborative decision-making process between health care providers and patients or their surrogates, taking into account the best scientific evidence available while considering the patient's values, goals, and preferences. Decision aids are tools enabling SDM. This article discusses shared decision making in general and in the intensive care unit in particular and facilitators and barriers for the creation and implementation of International Patient Decision Aids Standards Collaboration-compliant decision aids for the intensive care unit and neuro-intensive care unit...
April 2018: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/29492562/investigation-of-the-relationship-between-the-burden-of-raised-icp-and-the-length-of-stay-in-a-neuro-intensive-care-unit
#14
Martin Shaw, Laura Moss, Chris Hawthorne, John Kinsella, Ian Piper
OBJECTIVES: Raised intracranial pressure (ICP) is well known to be indicative of a poor outcome in traumatic brain injury (TBI). This phenomenon was quantified using a pressure time index (PTI) model of raised ICP burden in a paediatric population. Using the PTI methodology, this pilot study is aimed at investigating the relationship between raised ICP and length of stay (LOS) in adults admitted to a neurological intensive care unit (neuro-ICU). MATERIALS AND METHODS: In 10 patients admitted to the neuro-ICU following TBI, ICP was measured and data from the first 24 h were analysed...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29475026/results-of-interdisciplinary-management-of-693-patients-with-aneurysmal-subarachnoid-hemorrhage-clinical-outcome-and-relevant-prognostic-factors
#15
Muhammad AlMatter, Marta Aguilar Péreza, Pervinder Bhogal, Victoria Hellstern, Oliver Ganslandt, Hans Henkes
OBJECTIVES: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high rates of morbidities and fatalities. The continuous evolution of neurosurgical, endovascular and neuro-intensive cares has improved the overall mortality. In this study we sought to evaluate the clinical outcome after aSAH from a single tertiary center. PATIENTS AND METHODS: We retrospectively identified and reviewed all consecutive patients with aSAH treated at our center between 2007 and 2016...
April 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29422735/successful-use-of-ketamine-for-burst-suppression-in-super-refractory-status-epilepticus-following-substance-abuse
#16
Dnyaneshwar P Mutkule, S Manimala Rao, Jaydip Ray Chaudhuri, Kunche Rajasri
Status epilepticus is frequently encountered in neuro Intensive Care Units. It is a medical emergency and if not treated promptly can lead to severe brain damage and even death. Here, we present the case of a 18-year-old male with uncontrolled and unrelenting seizures with a rare etiology requiring ketamine infusion for burst suppression as it was resistant to thiopentone and midazolam infusions. The management of this case is presented in detail.
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29417604/effects-of-alcohol-on-the-brain-in-cirrhosis-beyond-hepatic-encephalopathy
#17
REVIEW
Brian C Davis, Jasmohan S Bajaj
Recent advances have led to a greater understanding of how alcohol alters the brain, both in acute stages (intoxication and alcohol withdrawal) and in chronic misuse. This review focuses on the current understanding of how alcohol affects the brain in cirrhosis patients with and without hepatic encephalopathy (HE). Chronic alcohol use is associated with nutritional deficiencies, dementia, cirrhosis, and decompensating events such as HE. Direct toxicity on brain tissue, induction of neuro-inflammation, and alcohol's alterations of the gut microbiome are possible mechanisms for the clinical features of HE associated with alcohol use...
April 2018: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/29415773/end-expiratory-occlusion-maneuver-to-predict-fluid-responsiveness-in-the-intensive-care-unit-an-echocardiographic-study
#18
Delphine Georges, Hugues de Courson, Romain Lanchon, Musa Sesay, Karine Nouette-Gaulain, Matthieu Biais
BACKGROUND: In mechanically ventilated patients, an increase in cardiac index during an end-expiratory-occlusion test predicts fluid responsiveness. To identify this rapid increase in cardiac index, continuous and instantaneous cardiac index monitoring is necessary, decreasing its feasibility at the bedside. Our study was designed to investigate whether changes in velocity time integral and in peak velocity obtained using transthoracic echocardiography during an end-expiratory-occlusion maneuver could predict fluid responsiveness...
February 8, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29405265/muscle-tone-assessments-for-children-aged-0-to-12-years-a-systematic-review
#19
REVIEW
Miran Goo, Kylie Tucker, Leanne M Johnston
AIM: The aim of this study was to identify and examine the psychometric properties of muscle tone assessments for children aged 0 to 12 years. METHOD: Four electronic databases were searched to identify studies that included assessments of resting and/or active muscle tone. Methodological quality and overall psychometric evidence of studies were rated using the COnsensus-based Standards for the selection of health Measurement INstruments checklist. RESULTS: Twenty-one assessments were identified from 97 included studies...
February 6, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29395511/healthcare-associated-infections-in-the-neurological-intensive-care-unit-results-of-a-6-year-surveillance-study-at-a-major-tertiary-care-center
#20
Yasser B Abulhasan, Susan P Rachel, Marc-Olivier Châtillon-Angle, Najayeb Alabdulraheem, Ian Schiller, Nandini Dendukuri, Mark R Angle, Charles Frenette
BACKGROUND: Healthcare-associated infections (HAIs) occur frequently in neurological intensive care units (neuro-ICUs); however, data differentiating associations with various diagnostic categories and resulting burdens are limited. This prospective cohort study reported incidence rates, pathogen distribution, and patient-related outcomes of HAIs in a neuro-ICU population from April 2010 to March 2016. METHODS: Laboratory results and specific clinical indicators were used to categorize infections as per National Healthcare Safety Network nosocomial infection surveillance definitions...
January 25, 2018: American Journal of Infection Control
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