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Craniotomy AND mechanical ventilation

Young Ha Jeong, So Hyun Kim, Eun Hee Choi, Kum Whang
OBJECTIVE: Of many critical care regimens, the management of physiological disturbances in serum is particularly drawing an attention in conjunction with patient outcome. The aim of this study was to assess the association of serum biochemical markers with mortality in head trauma patients with decompressive craniotomy. METHODS: Ninety six patients with acute subdural hematoma underwent decompressive craniectomy between January 2014 and December 2015. The clinical data and laboratory variables of these patients were recorded and analyzed retrospectively...
October 2016: Korean Journal of Neurotrauma
Dapeng Hou, Beibei Liu, Juan Zhang, Qiushi Wang, Wei Zheng
BACKGROUND While mild and moderate sedation have been widely used to reduce sudden agitation in intracerebral hemorrhage (ICH) patients after surgery, agitation is still a frequent problem, which may cause postoperative blood pressure fluctuation. The present study aimed to evaluate the efficacy and safety of short-course deep sedation for the treatment of ICH after surgery. MATERIAL AND METHODS A total of 41 ICH patients who received surgery, including traditional craniotomy hematoma removal and decompressive craniectomy, were including in this non-randomized control study...
July 28, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Hormuzdiyar H Dasenbrock, Robert F Rudy, William B Gormley, Timothy R Smith, Kai U Frerichs, Mohammad Ali Aziz-Sultan, Rose Du
INTRODUCTION: While obliteration of unruptured aneurysms reduces the risk of subarachnoid hemorrhage, perioperative complications impact the risk-benefit ratio of aneurysm repair, and additional data are needed to optimally risk-stratify patients preoperatively. METHODS: Patients who underwent craniotomy for microsurgical clipping of an unruptured aneurysm were extracted from the prospective National Surgical Quality Improvement Program (NSQIP) registry (2007-2014)...
August 2016: Neurosurgery
Asako Matsuda, Toshiyuki Mizota, Tomoharu Tanaka, Hajime Segawa, Kazuhiko Fukuda
We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased...
April 2016: Masui. the Japanese Journal of Anesthesiology
Jasmina Markovic-Bozic, Blaz Karpe, Iztok Potocnik, Ales Jerin, Andrej Vranic, Vesna Novak-Jankovic
BACKGROUND: The purpose of this randomised, single-centre study was to prospectively investigate the impact of anaesthetic techniques for craniotomy on the release of cytokines IL-6, IL-8, IL-10, and to determine whether intravenous anaesthesia compared to inhalational anaesthesia attenuates the inflammatory response. METHODS: The study enroled 40 patients undergoing craniotomy, allocated into two equal groups to receive either sevoflurane (n = 20) or propofol (n = 20) in conjunction with remifentanil and rocuronium...
March 22, 2016: BMC Anesthesiology
Jennifer E Fugate
PURPOSE OF REVIEW: This article provides an overview of the major neurologic complications of common neurosurgical and endovascular procedures. RECENT FINDINGS: Brain edema, seizures, postoperative hemorrhage, and cerebral ischemia can complicate neurosurgical procedures and produce neurologic decline. The high variability of reporting, types of operations, patient characteristics, and acuity of cases make estimating the incidence and severity of complications difficult...
October 2015: Continuum: Lifelong Learning in Neurology
Mengchan Ou, Zhen Luo, Juan Liu, Yaoxin Yang, Yu Li
We describe a case of negative pressure pulmonary edema that occurred in the post-anesthesia care unit in a patient who had undergone transsphenoidal resection of a pituitary adenoma. Negative pressure pulmonary edema is an uncommon complication of general anesthesia. In this case, the patient's nasal cavity had been filled with surgical packs and she had not become accustomed to breathing through her mouth, in addition to her large tongue and small oropharyngeal cavity, residual effect of anesthetic may resulting in tongue falling which caused airway obstruction...
2015: International Journal of Clinical and Experimental Medicine
Pavel Dostal, Jitka Schreiberova, Vlasta Dostalova, Vlasta Dostalova, Tomas Tyll, Jiri Paral, Islam Abdo, Miroslav Cihlo, David Astapenko, Zdenek Turek
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of mannitol and hypertonic saline (HTS) on cerebral cortical microcirculation in a rabbit craniotomy model. METHODS: Rabbits (weight, 2.0-3.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
2015: BMC Anesthesiology
Victoria T Trinh, Jason M Davies, Mitchel S Berger
OBJECT: The object of this study was to examine how procedural volume and patient demographics impact complication rates and value of care in those who underwent biopsy or craniotomy for supratentorial primary brain tumors. METHODS: The authors conducted a retrospective cohort study using data from the Nationwide Inpatient Sample (NIS) on 62,514 admissions for biopsy or resection of supratentorial primary brain tumors for the period from 2000 to 2009. The main outcome measures were in-hospital mortality, routine discharge proportion, length of hospital stay, and perioperative complications...
February 2015: Journal of Neurosurgery
Ashish Bindra, Rajendra S Chouhan, Hemanshu Prabhakar, P Sarat Chandra, Manjari Tripathi
PURPOSE: Drug-resistant epilepsy (DRE) occurs in about 30 % of individuals with epilepsy. For seizure control, a wide range of surgical procedures are performed, depending on the underlying pathology. To address the anesthetic and perioperative concerns in these patients, we analyzed the data of persons with DRE who underwent epilepsy surgery at our institute. METHODS: A retrospective analysis of patients who underwent epilepsy surgery from 2005-2010 was performed...
April 2015: Journal of Anesthesia
Shaun E Gruenbaum, Keith J Ruskin
PURPOSE OF REVIEW: Anemia is common in neurosurgical patients, and is associated with secondary brain injury. Although recent studies in critically ill patients have shifted practice toward more restrictive red blood cell (RBC) transfusion strategies, the evidence for restrictive versus liberal transfusion strategies in neurosurgical patients has been controversial. In this article, we review recent studies that highlight issues in RBC transfusion in neurosurgical patients. RECENT FINDINGS: Recent observational, retrospective studies in patients with traumatic brain injury, subarachnoid hemorrhage, and intracranial hemorrhage have demonstrated that prolonged anemia and RBC transfusions were associated with worsened outcomes...
October 2014: Current Opinion in Anaesthesiology
Alana M Flexman, Bradley Merriman, Donald E Griesdale, Kelly Mayson, Peter T Choi, Christopher J Ryerson
BACKGROUND: Respiratory failure and death are devastating outcomes in the postoperative period. Patients undergoing neurosurgical procedures experience a greater frequency of respiratory failure compared with other surgical specialties. Resection of infratentorial mass lesions may be associated with an even higher risk because of several unique factors. Our objectives were: (1) to determine the incidence of postoperative respiratory failure and death in the neurosurgical population; and (2) to determine whether infratentorial procedures are associated with a higher risk compared with supratentorial procedures...
July 2014: Journal of Neurosurgical Anesthesiology
Yan-ping Qiu, Yong-ju Chen, Rong-rong Song, Gang Wang, Jian-jun Guan, Hao-liang Ni, Yong Ji
OBJECTIVE: To investigate the safety and effects of early bronchoscopy on atelectasis of the ventilation patients, whom had experienced craniotomy for severe cranial trauma and hemorrhage. METHODS: Fifty-five patients suffered from severe cranial trauma and hemorrhage with Glascow coma scores (GCS) less than 8 complicated by atelectasis after craniotomy were early given sputum suction by bronchoscope via extratracheal intubation and broncho-alveolar lavage (BAL) during tracheal intubation and mechanical ventilation...
December 2012: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
K U Klein, S Boehme, E K Hartmann, M Szczyrba, L Heylen, T Liu, M David, C Werner, K Markstaller, K Engelhard
BACKGROUND: Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI) leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa(O(2))). These Pa(O(2)) oscillations could also be forwarded to the cerebral microcirculation. METHODS: In 12 pigs, partial pressure of oxygen was measured in the thoracic aorta (Pa(O(2))) and subcortical cerebral tissue (Pbr(O(2))). Cerebral cortical haemoglobin oxygen saturation (Sbr(O(2))), cerebral blood flow (CBF), and peripheral haemoglobin saturation (Sp(O(2))) were assessed by spectroscopy and laser Doppler flowmetry...
February 2013: British Journal of Anaesthesia
Nicolas Côte, Alexis F Turgeon, François Lauzier, Lynne Moore, Damon C Scales, Francis Bernard, Ryan Zarychanski, Karen E A Burns, Maureen O Meade, David Zygun, Jean-François Simard, Amélie Boutin, Jacques G Brochu, Dean A Fergusson
PURPOSE: To identify factors associated with decisions to withdraw life-sustaining therapies in patients with severe traumatic brain injury (TBI). MATERIALS AND METHODS: We conducted a 2-year multicenter retrospective cohort study (2005-2006) in mechanically ventilated patients aged 16 years and older admitted to the intensive care units (ICUs) of six Canadian level I trauma centers following severe TBI. One hundred and twenty charts were randomly selected at each center (n = 720)...
February 2013: Neurocritical Care
Tyler J Kenning, M Reid Gooch, Ravi H Gandhi, M Parvez Shaikh, Alan S Boulos, John W German
OBJECT: Recent randomized trials have demonstrated a positive role (improved survival) in patients treated with cranial decompression for malignant cerebral infarction. However, many variables regarding operative decompression in this setting remain to be determined. Hinge craniotomy is an alternative to decompressive craniectomy, but its role in space-occupying cerebral infarctions has not been delineated. The objective of this study was to compare the authors' experiences with these 2 procedures in the management of space-occupying cerebral infarctions to determine the efficacy of each...
June 2012: Journal of Neurosurgery
Michal Sitina, Zdenek Turek, Renata Parizkova, Christian Lehmann, Vladimir Cerny
The purpose of our study was to evaluate changes of the cerebral microcirculation during the early stages of endotoxemia in mechanically-ventilated rabbits using Sidestream dark-field (SDF) imaging. Images were obtained using SDF imaging from the surface of the brain via craniotomy before and after rapid administration of a high dose of endotoxin or saline (control group). Although endotoxin shock was successfully induced, we have not found any significant alteration of the cerebral microcirculation during the shock...
2011: Clinical Hemorheology and Microcirculation
Mypinder S Sekhon, Vinay K Dhingra, Indeep S Sekhon, William R Henderson, Neilson McLean, Donald E G Griesdale
PURPOSE: Although 4% albumin is associated with increased mortality in patients with traumatic brain injury (TBI), evidence concerning the safety of synthetic colloids is lacking. We aimed to determine if there is an association between synthetic colloids and mortality in patients with severe TBI. MATERIALS AND METHODS: A retrospective cohort study of patients with severe TBI was conducted. Data were collected on all intravenous fluids administered during the first 14 days of admission...
August 2011: Journal of Critical Care
Ossam Rhondali, Céline Genty, Caroline Halle, Marianne Gardellin, Céline Ollinet, Manuela Oddoux, Joëlle Carcey, Gilles Francony, Bertrand Fauvage, Emmanuel Gay, Jean-Luc Bosson, Jean-François Payen
BACKGROUND: After elective craniotomy for brain surgery, patients are usually admitted to an intensive care unit (ICU). We sought to identify predictors of postoperative complications to define perioperative conditions that would safely allow ICU bypass. METHODS: This observational cohort study enrolled 358 patients admitted to neuro-ICU after elective intracranial procedures. Postoperative complications were defined as unexpected events occurring within 24 hours of surgery that required imaging or treatment for neurologic deterioration...
April 2011: Journal of Neurosurgical Anesthesiology
Shailendra Joshi, Aysegul Ergin, Mei Wang, Roberto Reif, Jane Zhang, Jeffrey N Bruce, Irving J Bigio
The novel ability to quantify drug and tracer concentrations in vivo by optical means leads to the possibility of detecting and quantifying blood brain barrier (BBB) disruption in real-time by monitoring concentrations of chromophores such as Evan's Blue. In this study, experiments were conducted to assess the disruption of the BBB, by intraarterial injection of mannitol, in New Zealand white rabbits. Surgical preparation included: tracheotomy for mechanical ventilation, femoral and selective internal carotid artery (ICA) catheterizations, skull screws for monitoring electrocerebral activity, bilateral placement of laser Doppler probes and a small craniotomy for the placement of a fiber optic probe to determine tissue Evan's Blue dye concentrations...
August 2011: Journal of Neuro-oncology
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