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Neuro Intensive Care

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https://www.readbyqxmd.com/read/28054288/post-traumatic-stress-disorder-and-complicated-grief-are-common-in-caregivers-of-neuro-icu-patients
#1
Stephen A Trevick, Aaron S Lord
BACKGROUND: To explore the effect of end of life and other palliative decision making scenarios on the mental health of family members of patients in the neuro-intensive care unit. METHODS: Decision makers of patients in the neuro-ICU at a large, urban, academic medical center meeting palliative care triggers were identified from November 10, 2014, to August 27, 2015. Interviews were conducted at 1 and 6 months post-enrollment. At 1 month, the Inventory of Complicated Grief-Revised (ICG-R), Impact of Events Scale-Revised (IES-R), and the Family Satisfaction-ICU (FS-ICU) were performed along with basic demographic questionnaires...
January 4, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28030487/neuro-trauma-or-med-surg-icu-does-it-matter-where-polytrauma-patients-with-tbi-are-admitted-secondary-analysis-of-aast-mitc-decompressive-craniectomy-study
#2
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Gregory J Jurkovich, Ram Nirula
INTRODUCTION: Patients with non-traumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without TBI fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28009337/wireless-multichannel-electroencephalography-in-the-newborn
#3
Z H Ibrahim, G Chari, S Abdel Baki, V Bronshtein, M R Kim, J Weedon, J Cracco, J V Aranda
OBJECTIVES: First, to determine the feasibility of an ultra-compact wireless device (microEEG) to obtain multichannel electroencephalographic (EEG) recording in the Neonatal Intensive Care Unit (NICU). Second, to identify problem areas in order to improve wireless EEG performance. STUDY DESIGN: 28 subjects (gestational age 24-30 weeks, postnatal age <30 days) were recruited at 2 sites as part of an ongoing study of neonatal apnea and wireless EEG. Infants underwent 8-9 hour EEG recordings every 2-4 weeks using an electrode cap (ANT-Neuro) connected to the wireless EEG device (Bio-Signal Group)...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28000130/early-mobilization-in-the-neuro-icu-how-far-can-we-go
#4
Brian F Olkowski, Syed Omar Shah
Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27995066/functional-resting-state-fmri-connectivity-correlates-with-serum-levels-of-the-s100b-protein-in-the-acute-phase-of-traumatic-brain-injury
#5
William Hedley Thompson, Eric Peter Thelin, Anders Lilja, Bo-Michael Bellander, Peter Fransson
The S100B protein is an intra-cellular calcium-binding protein that mainly resides in astrocytes in the central nervous system. The serum level of S100B is used as biomarker for the severity of brain damage in traumatic brain injury (TBI) patients. In this study we investigated the relationship between intrinsic resting-state brain connectivity, measured 1-22 days (mean 8 days) after trauma, and serum levels of S100B in a patient cohort with mild-to-severe TBI in need of neuro-intensive care in the acute phase...
2016: NeuroImage: Clinical
https://www.readbyqxmd.com/read/27987330/protection-of-dexmedetomidine-against-ischemia-reperfusion-induced-apoptotic-insults-to-neuronal-cells-occurs-via-an-intrinsic-mitochondria-dependent-pathway
#6
Gong-Jhe Wu, Jui-Tai Chen, Hsiao-Chien Tsai, Ta-Liang Chen, Shing-Hwa Liu, Ruei-Ming Chen
Dexmedetomidine, an agonist of alpha2-adrenergic receptors, is used for critically ill patients to induce and maintain sedation and analgesia. Brain ischemia/reperfusion (I/R) usually causes severe neuronal injuries to intensive care unit patients. This study was aimed to evaluate the effects of dexmedetomidine on I/R-induced insults to neuronal cells and the possible mechanisms. Treatment of neuro-2a cells with dexmedetomidine did not affect cell viability but could protect against I/R-induced cell death. Separately, the I/R-triggered cell shrinkage, DNA fragmentation, and apoptosis in neuro-2a cells were alleviated by dexmedetomidine...
December 17, 2016: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/27928632/ventriculostomy-related-infections-in-subarachnoid-hemorrhage-patients-a-retrospective-study-of-incidence-etiology-and-antimicrobial-therapy
#7
Johan Widén, Britt-Marie Eriksson, Elisabeth Ronne-Engström, Per Enblad, Gabriel Westman
BACKGROUND: This study was performed to investigate the incidence and etiology of ventriculostomy-related infections (VRIs) in patients with subarachnoid hemorrhage (SAH) and to assess adherence to local clinical guidelines regarding empirical antimicrobial therapy and diagnostic routines. METHODS: A total of 191 consecutive SAH patients treated in the neuro-intensive care unit of Uppsala University Hospital between 2010 and 2013 were included retrospectively. Information regarding cerebrospinal fluid samples, bacterial cultures, ventriculostomy treatment, patient characteristics, and antibiotic treatment were collected from electronic patient records...
December 7, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27907954/today-s-approach-to-treating-brain-swelling-in-the-neuro-intensive-care-unit
#8
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
#9
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, the symptoms of patients 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
#10
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
#11
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
#12
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
#13
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...
February 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27749460/utility-of-continuous-eeg-monitoring-in-noncritically-lll-hospitalized-patients
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
REVIEW
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
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