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https://www.readbyqxmd.com/read/27836262/tissue-interface-pressure-and-skin-integrity-in-critically-ill-mechanically-ventilated-patients
#1
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...
November 8, 2016: 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/21327576/posterior-reversible-encephalopathy-syndrome-associated-with-hemodynamic-augmentation-in-aneurysmal-subarachnoid-hemorrhage
#15
Elias A Giraldo, Jennifer E Fugate, Alejandro A Rabinstein, Giuseppe Lanzino, Eelco F M Wijdicks
BACKGROUND: Cerebral vasospasm has become the most concerning complication in patients with aneurysmal subarachnoid hemorrhage (aSAH) seen in the neurosciences intensive care unit (NSICU). Hemodynamic augmentation is frequently used to treat cerebral ischemia from vasospasm. In the last 5 years, posterior reversible encephalopathy syndrome (PRES) has been reported in three single case reports as a complication of hemodynamic augmentation. We describe an additional three patients seen in our institution...
June 2011: Neurocritical Care
https://www.readbyqxmd.com/read/20465454/release-of-vegf-and-fgf-in-the-extracellular-space-following-severe-subarachnoidal-haemorrhage-or-traumatic-head-injury-in-humans
#16
Pekka Mellergård, Florence Sjögren, Jan Hillman
Microdialysate fluid from 145 severely injured NSICU-patients, 88 with subarachnoidal haemorrage (SAH), and 57 with traumatic brain injury (TBI), was collected by microdialysis during the first 7 days following impact, and levels of the neurotrophins fibroblast growth factor-2 (FGF2) and vascular endothelial growth factor (VEGF) were analysed. The study illustrates both similarities and differences in the reaction patterns of the 2 inflammatory proteins. The highest concentrations of both FGF2 and VEGF were measured on Day 2 (mean (+/- SE) values being 47...
June 2010: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/19898966/prospective-randomized-single-blinded-comparative-trial-of-intravenous-levetiracetam-versus-phenytoin-for-seizure-prophylaxis
#17
RANDOMIZED CONTROLLED TRIAL
Jerzy P Szaflarski, Kiranpal S Sangha, Christopher J Lindsell, Lori A Shutter
BACKGROUND: Anti-epileptic drugs are commonly used for seizure prophylaxis after neurological injury. We performed a study comparing intravenous (IV) levetiracetam (LEV) to IV phenytoin (PHT) for seizure prophylaxis after neurological injury. METHODS: In this prospective, single-center, randomized, single-blinded comparative trial of LEV versus PHT (2:1 ratio) in patients with severe traumatic brain injury (sTBI) or subarachnoid hemorrhage (NCT00618436) patients received IV load with either LEV or fosphenytoin followed by standard IV doses of LEV or PHT...
April 2010: Neurocritical Care
https://www.readbyqxmd.com/read/19446709/emotional-distress-coping-and-adjustment-in-family-members-of-neuroscience-intensive-care-unit-patients
#18
Jennifer E Wartella, Stephen M Auerbach, Kevin R Ward
OBJECTIVE: We evaluated emotional distress, coping strategy use, caregiver adjustment, and the relationship among these variables in family members (FMs) of patients hospitalized in a neuroscience intensive care unit (NSICU). METHODS: Fifty-one primary relatives of NSICU patients were administered the Brief Symptom Inventory (BSI) and an abbreviated version of the COPE within 2 days of admission to the NSICU, just prior to patient discharge from the unit, and approximately 30 days after patient discharge (follow-up)...
June 2009: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/19238588/symptomatic-venous-thromboembolism-incidence-and-risk-factors-in-patients-with-spontaneous-or-traumatic-intracranial-hemorrhage
#19
Keri S Kim, Gretchen M Brophy
OBJECTIVES: The objectives of this study are to determine the incidence of symptomatic venous thromboembolism (VTE) in neurosurgery intensive care unit (NSICU) patients with spontaneous or traumatic intracranial hemorrhage and to identify the common VTE risk factors by injury type. METHODS: This retrospective, single-center cohort study included adult patients admitted to the NSICU between January 2001 and July 2004 with a primary diagnosis of subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), or traumatic brain injury (TBI)...
2009: Neurocritical Care
https://www.readbyqxmd.com/read/19084290/neurosurgically-related-nosocomial-acinetobacter-baumannii-meningitis-report-of-two-cases-and-literature-review
#20
REVIEW
V Krol, N S Hamid, B A Cunha
Nosocomial meningitis is an uncommon complication of neurosurgical procedures, although nosocomial Gram-negative bacillary meningitis does occur occasionally in neurosurgical intensive care units (NSICUs). Acinetobacter baumannii is a rare cause of nosocomial meningitis, and is an even rarer cause of meningitis outbreaks in NSICUs. We report two cases of A. baumannii meningitis in an NSICU due to suboptimal aseptic technique in obtaining cerebrospinal fluid (CSF) specimens. After institution of infection control measures, i...
February 2009: Journal of Hospital Infection
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