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https://www.readbyqxmd.com/read/28524031/-predictive-value-of-cerebrospinal-fluid-lactate-for-the-diagnosis-of-bacterial-meningitis-in-patients-post-neurosurgical-operation-with-blood-contaminated-cerebrospinal-fluid
#1
Yufang Wang, Lingyan Wang, Jingchao Li, Lei Shi, Mingli Yao, Xiangdong Guan, Bin Ouyang
OBJECTIVE: To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). METHODS: A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28480662/impact-of-neurointensivist-co-management-on-the-clinical-outcomes-of-patients-admitted-to-a-neurosurgical-intensive-care-unit
#2
Jeong Am Ryu, Jeong Hoon Yang, Chi Ryang Chung, Gee Young Suh, Seung Chyul Hong
Limited data are available on improved outcomes after initiation of neurointensivist co-management in neurosurgical intensive care units (NSICUs) in Korea. We evaluated the impact of a newly appointed neurointensivist on the outcomes of neurosurgical patients admitted to an intensive care unit (ICU). This retrospective observational study involved neurosurgical patients admitted to the NSICU at Samsung Medical Center between March 2013 and May 2016. Neurointensivist co-management was initiated in October 1 2014...
June 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28323659/stimulus-induced-rhythmic-periodic-or-ictal-discharges-in-coma-incidence-and-interrater-reliability-of-continuous-eeg-after-a-standard-stimulation-protocol-a-prospective-study
#3
Khalid A Alsherbini, Joao Mc-OʼNeil Plancher, David M Ficker, Brandon P Foreman, Opeolu M Adeoye, Jun Ying, Michael D Privitera
PURPOSE: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG. METHODS: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded...
March 17, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#4
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27995512/clevidipine-versus-nicardipine-for-acute-blood-pressure-reduction-in-a-neuroscience-intensive-care-population
#5
Jacqueline R Finger, Lisa M Kurczewski, Gretchen M Brophy
BACKGROUND: Currently, a lack of published literature exists regarding the use of clevidipine in the neuroscience population. This agent may be preferred in some patients because of its short half-life, potentially leading to more narrow blood pressure (BP) control in comparison with other agents. The purpose of this study was to compare the difference in time to achieve target systolic blood pressure (SBP) goals with clevidipine versus nicardipine infusions in patients admitted to the neuroscience intensive care unit (NSICU) at our institution...
April 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27960070/comparison-of-two-surface-cooling-devices-for-temperature-management-in-a-neurocritical-care-unit
#6
Gurpreet Singh Aujla, Premkumar Nattanmai, Keerthivaas Premkumar, Christopher R Newey
Fever increases mortality and morbidity and length of stay in neurocritically ill patients. Various methods are used in the neuroscience intensive care unit (NSICU) to control fever. Two such methods involve the Arctic Sun hydrogel wraps and the Gaymar cooling wraps. The purpose of our study was to compare these two methods in neurocritical care patients who had temperature >37.5°C for more than three consecutive hours and that was refractory to standard treatments. Data of patients requiring cooling wraps for treatment of hyperthermia at an NSICU at an academic, tertiary referral center were retrospectively reviewed...
December 13, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27836262/tissue-interface-pressure-and-skin-integrity-in-critically-ill-mechanically-ventilated-patients
#7
Mary Jo Grap, Cindy L Munro, Paul A Wetzel, Christine M Schubert, Anathea Pepperl, Ruth S Burk, Valentina Lucas
OBJECTIVE: To describe tissue interface pressure, time spent above critical pressure levels and the effect on skin integrity at seven anatomical locations. DESIGN, SETTING, PATIENTS: Descriptive, longitudinal study in critically ill mechanically ventilated adults, from Surgical Trauma ICU-STICU; Medical Respiratory ICU-MRICU; Neuroscience ICU-NSICU in a Mid-Atlantic urban university medical centre. Subjects were enroled in the study within 24hours of intubation...
February 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/27399466/187%C3%A2-prospective-study-of-futile-care-in-the-neuroscience-intensive-care-unit
#8
Simon Buttrick, Kristy OʼPhelan, Kenneth Goodman, Ronald Jay Benveniste
INTRODUCTION: Our health care system spends a significant amount of resources on futile care, ie, continued medical therapy when there is no reasonable hope of cure or benefit. Nowhere is this more evident than in the neuroscience intensive care unit (NSICU), because intensive care medicine has become exceedingly proficient at maintaining cardiopulmonary function even in the face of catastrophic brain injury. METHODS: We identified patients who were admitted to the NSICU with partial loss of brainstem reflexes even after initial stabilization...
August 2016: Neurosurgery
https://www.readbyqxmd.com/read/27351176/intravenous-versus-oral-acetaminophen-for-pain-control-in-neurocritical-care-patients
#9
Dan C Nichols, Pramit A Nadpara, Perry D Taylor, Gretchen M Brophy
BACKGROUND: Acetaminophen (APAP) is used in neurocritical care (NCC) patients for analgesia without sedation or antiplatelet activity. Research suggests that intravenous (IV) APAP produces earlier and higher serum levels compared to oral (PO) APAP. This retrospective study evaluates the associated analgesic effects of IV and PO APAP and use of adjunctive opioids in NCC patients with moderate-severe pain. METHODS: Patients admitted to the neuroscience intensive care unit (NSICU) between May 2012 and April 2013 who received ≥1 dose of IV APAP were included in the study...
December 2016: Neurocritical Care
https://www.readbyqxmd.com/read/25896810/blood-pressure-guideline-adherence-in-patients-with-ischemic-and-hemorrhagic-stroke-in-the-neurointensive-care-unit-setting
#10
Guilherme B F Porto, Alejandro M Spiotta, Julio A Chalela, Ryan T Kellogg, Edward C Jauch
BACKGROUND AND PURPOSE: Patients with acute brain injuries require strict physiologic control to minimize morbidity and mortality. This study aimed to assess in-hospital compliance to strict physiologic parameters (BP, HR, ICP, SpO2) in these populations. METHODS: Patients with severe cerebrovascular events were admitted to the neurointensive care unit (NSICU) and were continuously monitored using the BedMasterEX (Excel Medical Electronics Inc, FL) system, which recorded hemodynamic data via an arterial catheter continuously in 5-s intervals...
December 2015: Neurocritical Care
https://www.readbyqxmd.com/read/25271678/an-audit-of-continuous-eeg-monitoring-in-the-neurological-neurosurgical-intensive-care-unit
#11
Nitin K Sethi, Beth S Rapaport, Gail E Solomon
PURPOSE: The use of long-term continuous EEG (cEEG) monitoring in neurological-neurosurgical intensive care units (NSICU) has witnessed an exponential increase. We decided to do an audit of the long-term cEEG monitoring in our NSICU over the past 7 years (2005-2011). The study was performed to determine technical and staffing consideration for the future. METHODS: An audit of all long-term cEEG monitoring studies in our NSICU from 2005 through 2011. RESULTS: We found a dramatic increase in the use of the cEEG monitoring in our NSICU over the 7-year period...
October 2014: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/25065844/diurnal-salivary-cortisol-measurement-in-the-neurosurgical-surgical-intensive-care-unit-in-critically-ill-acute-trauma-patients
#12
Viktor Bartanusz, Michael G Corneille, Salvador Sordo, Marianne Gildea, Joel E Michalek, Prakash V Nair, Ronald M Stewart, Daniela Jezova
Acute trauma patients represent a specific subgroup of the critically ill population due to sudden and dramatic changes in homeostasis and consequently extreme demands on the activity of the hypothalamic-pituitary-adrenocortical (HPA) axis. Salivary cortisol is an accepted surrogate for serum free cortisol in the assessment of HPA axis function. The purpose of this study was (1) to establish the feasibility of salivary cortisol measurement in acute trauma patients in the neurosurgical-surgical intensive care unit (NSICU), and (2) to determine the diurnal pattern of salivary cortisol in the acute phase after injury...
December 2014: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/25047317/complications-of-peripherally-inserted-central-venous-catheters-in-neonates-lesson-learned-over-2-years-in-a-tertiary-care-centre-in-india
#13
Amit Singh, Minu Bajpai, Shasanka Shekhar Panda, Manisha Jana
BACKGROUND: The objective of this study was to assess the complications of peripherally inserted central venous catheters (PICC) in neonates admitted to neonatal surgical intensive care unit (NSICU). PATIENTS AND METHODS: Retrospective analysis of 237 neonates admitted to NSICU from January 2010 to December 2011 was done. RESULTS: Mean age at presentation was 5.8 days and mean weight was 1.94 kg. Mean number of attempts was 1.14, mean duration of insertion 8...
July 2014: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/24805007/potentially-inappropriate-medication-use-is-associated-with-clinical-outcomes-in-critically-ill-elderly-patients-with-neurological-injury
#14
Catherine K Floroff, Patricia W Slattum, Spencer E Harpe, Perry Taylor, Gretchen M Brophy
BACKGROUND: Limited data suggest that potentially inappropriate medications (PIMs) impact outcomes in critically ill elderly patients. No data are available on the association between PIM use as well as drug burden index (DBI), which is a measure of PIM use, and clinical outcomes in neurocritical care elderly patients. This study evaluates whether PIM use and a higher DBI are associated with poor clinical outcomes in neurocritical care elderly patients. METHODS: PIMs were retrospectively identified in critically ill elderly patients admitted to the neuroscience intensive care unit (NSICU) from March to July 2011...
December 2014: Neurocritical Care
https://www.readbyqxmd.com/read/24091431/reduction-of-ventilator-associated-pneumonia-in-the-neuroscience-intensive-care-unit-a-multimodality-prevention-and-testing-protocol
#15
M Johnson, B Rocque, T Kamps, J Medow
AIM: Ventilator-associated pneumonia (VAP) is a serious concern for patients in the Neuroscience Intensive Care Unit (NSICU). The risks to patients are significant and the monetary costs are astronomical. We review a multimodality approach that substantially reduced VAP rate in our ICU METHODS: Data from all patients admitted to the NSICU between January 2005 and April 2010 were reviewed. All ventilated patients were treated according to a multimodality VAP assessment and prevention protocol, implementation of which began in August of 2008 and was completed by March 2009...
December 2013: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/23878765/clinical-approach-to-fever-in-the-neurosurgical-intensive-care-unit-focus-on-drug-fever
#16
Burke A Cunha
As fever is one of the cardinal signs of infection, the presence of fever in a patient in the neurosurgical intensive care unit (NSICU) raises the question of whether it is infectious in etiology. Infectious and noninfectious causes of fever in the NSICU may be determined based upon assessment of clinical signs and symptoms, the degree of temperature elevation, the relationship of the pulse to the fever (e.g., an infectious process resulting in hyperpyrexia and bradycardia), and when the fever occurs (e.g., related to the length of stay in the NSICU)...
2013: Surgical Neurology International
https://www.readbyqxmd.com/read/23099845/safety-of-a-dvt-chemoprophylaxis-protocol-following-traumatic-brain-injury-a-single-center-quality-improvement-initiative
#17
COMPARATIVE STUDY
Christopher M Nickele, Timothy K Kamps, Joshua E Medow
BACKGROUND: Venous thromboembolism (VTE) is a complication that affects approximately 30 % of moderate and severe traumatic brain injury (TBI) patients when pharmacologic prophylaxis is not used. Following TBI, specifically in the case of contusions, the safety and efficacy of pharmacologic thromboembolism prophylaxis (PTP) has been studied only in small sample sizes. In this study, we attempt to assess the safety and efficacy of a PTP protocol for TBI patients, as a quality improvement (QI) initiative, in the neuroscience intensive care unit (NSICU)...
April 2013: Neurocritical Care
https://www.readbyqxmd.com/read/22038112/molecular-epidemiology-and-the-clinical-significance-of-acinetobacter-baumannii-complex-isolated-from-cerebrospinal-fluid-in-neurosurgical-intensive-care-unit-patients
#18
G Bayramoglu, S Kaya, Y Besli, E Cakır, G Can, O Akıneden, F Aydin, I Koksal
OBJECTIVE: This study was intended to investigate the clinical significance and molecular epidemiology of Acinetobacter baumannii complex (ABC) isolated from cerebrospinal fluid (CSF) in neurosurgical intensive care unit (NSICU) patients, particularly comparing isolates from healthcare workers' (HCW) hands. METHODS: We retrospectively reviewed the medical records of 30 patients with CSF cultures positive for ABC seen at our NSICU from the date it first opened, January 2007, to September 2010...
April 2012: Infection
https://www.readbyqxmd.com/read/21988111/the-cerebral-extracellular-release-of-glycerol-glutamate-and-fgf2-is-increased-in-older-patients-following-severe-traumatic-brain-injury
#19
Pekka Mellergård, Florence Sjögren, Jan Hillman
Old age is associated with a poor recovery from traumatic brain injury (TBI). In a retrospective study we investigated if the biochemical response following TBI is age dependent. Extracellular fluids were continuously sampled by microdialysis in 69 patients admitted to our NSICU following severe TBI. The concentrations of glycerol, glutamate, lactate, pyruvate, and eight different cytokines (IL-1β, IL-6, IL-10, IL-8, MIP-1β, RANTES, FGF2, and VEGF) were determined by fluorescence multiplex bead technology...
January 1, 2012: Journal of Neurotrauma
https://www.readbyqxmd.com/read/21593685/predictive-model-for-survival-among-neurosurgical-intensive-care-patients
#20
Venkatapura J Ramesh, Ganne S Umamaheswara Rao, Thennarasu Kandavel, Subbakrishna D Kumaraswamy, Udaya B Iyyamanda, Bangalore A Chandramouli
BACKGROUND: Models for prediction of outcome of intensive care patients greatly help the physician to make decisions and are also important for risk stratification in clinical research and quality improvement. At present, there are no major predictive models for neurosurgical intensive care unit (NSICU) patients. This study aimed to develop a predictive model for survival in NSICU patients. METHODS: This is a prospective observational study in the NSICU at a tertiary-care university hospital...
July 2011: Journal of Neurosurgical Anesthesiology
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