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https://www.readbyqxmd.com/read/27886628/eeg-utilization-in-canadian-intensive-care-units-a-multicentre-prospective-observational-study
#1
Andrea Park, Martin Chapman, Victoria A McCredie, Derek Debicki, Teneille Gofton, Loretta Norton, J Gordon Boyd
PURPOSE: We have previously shown that electroencephalography (EEG) may be an underutilized monitoring modality in a single general medical-surgical ICU, that does not have a specific neurocritical care consultation service or neurocritical care unit. The present study was designed to describe the pattern of EEG utilization across 3 academic ICUs in Ontario, Canada that use different models of neurocritical care. METHOD: In this prospective multicentre observational study, ICU patients were screened weekly for 6 non-consecutive weeks to determine if they met the ESICM's recommendations or suggestions for EEG monitoring...
November 13, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27856137/therapeutic-hypothermia-and-inhalation-anesthesia-in-a-patient-with-severe-pneumococcal-meningitis-and-secondary-cardiac-arrest
#2
Nejc Bukovnik, Andrej Markota, Tomaž Velnar, Janez Rebol, Andreja Sinkovič
Therapeutic hypothermia was associated with increased mortality in patients with severe bacterial meningitis in a large randomized trial. It still remains a treatment strategy for comatose survivors of cardiac arrest. There are several potential advantages of inhalational anesthetics as long-term sedation agents compared to intravenous sedation, however, uncontrollable increases of intracranial pressure were observed in neurocritical patients. Here we present a patient with severe bacterial meningitis and secondary cardiac arrest where therapeutic hypothermia and inhalational anesthesia were successfully used...
November 2, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27850227/587-outcomes-after-percutaneous-endoscopic-gastrostomy-in-neurocritical-care-patients
#3
Andreea Xavier, Kim Vu, Jade Woellner, Stephanie Cooper, Maria DeGuzmann, Hope Moser, Jeremy Ragland, Huimahn Choi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849864/222-increased-rate-and-earlier-onset-of-picc-related-thrombosis-in-neurocritical-patients
#4
Myrna Wallace-Servera, Steve Hartzman, Stuart Braverman, Manu Singh
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27814782/spanish-consensus-for-the-management-of-sinonasal-tumors
#5
Fernando López, Juan José Grau, José Antonio Medina, Isam Alobid
Sinonasal tumors are rare neoplasms with distinctive clinical, aetiological and pathological features. The diagnosis and treatment of these tumours is challenging because of their low incidence, histological diversity and production of non-specific symptoms in the early stages. They have a variable prognosis depending on their histology, origin and staging. Their location, close to neurocritical structures, which are of special relevance to surgery and postoperative treatment, makes their treatment difficult and complex, leading to high morbidity and mortality...
November 1, 2016: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/27776537/cerebrospinal-fluid-penetration-of-meropenem-in-neurocritical-care-patients-with-proven-or-suspected-ventriculitis-a-prospective-observational-study
#6
Ute Blassmann, Anka C Roehr, Otto R Frey, Cornelia Vetter-Kerkhoff, Niklas Thon, William Hope, Josef Briegel, Volker Huge
BACKGROUND: Ventriculitis is a complication of temporary intraventricular drains. The limited penetration of meropenem into the cerebrospinal fluid (CSF) is well known. However, ventricular CSF pharmacokinetic data in patients with ventriculitis are lacking. The aim of this study was to evaluate meropenem pharmacokinetics in the serum and CSF of neurocritical care patients with proven or suspected ventriculitis. METHODS: We conducted an observational pharmacokinetic study of neurocritical care patients with proven or suspected ventriculitis receiving meropenem...
October 24, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27757914/risks-of-routinely-clamping-external-ventricular-drains-for-intrahospital-transport-in-neurocritically-ill-cerebrovascular-patients
#7
Nophanan Chaikittisilpa, Abhijit V Lele, Vivian H Lyons, Bala G Nair, Shu-Fang Newman, Patricia A Blissitt, Monica S Vavilala
BACKGROUND: Current guidelines recommend routine clamping of external ventricular drains (EVD) for intrahospital transport (IHT). The aim of this project was to describe intracranial hemodynamic complications associated with routine EVD clamping for IHT in neurocritically ill cerebrovascular patients. METHODS: We conducted a retrospective review of cerebrovascular adult patients with indwelling EVD admitted to the neurocritical care unit (NICU) during the months of September to December 2015 at a tertiary care center...
October 18, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27742889/reappraisal-of-the-reference-levels-for-energy-metabolites-in-the-extracellular-fluid-of-the-human-brain
#8
Angela Sánchez-Guerrero, Gemma Mur-Bonet, Marian Vidal-Jorge, Darío Gándara-Sabatini, Ivette Chocrón, Esteban Cordero, Maria-Antonia Poca, Katharine Mullen, Juan Sahuquillo
Cerebral microdialysis is widely used in neurocritical care units. The goal of this study was to establish the reference interval for the interstitial fluid concentrations of energy metabolites and glycerol by using the extrapolation to zero-flow methodology in anesthetized patients and by constant perfusion at 0.3 µL/min in awake patients. A CMA-71 probe was implanted during surgery in normal white matter of patients with posterior fossa or supratentorial lesions, and the perfusion flow rate was randomized to 0...
October 14, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27673345/early-physiotherapy-by-passive-range-of-motion-does-not-affect-partial-brain-tissue-oxygenation-in-neurocritical-care-patients
#9
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/27647155/implementation-of-a-neurocritical-care-program-improved-seizure-detection-and-decreased-antiseizure-medication-at-discharge-in-neonates-with-hypoxic-ischemic-encephalopathy
#10
Rani Ameena Bashir, Liza Espinoza, Sakeer Vayalthrikkovil, Jeffrey Buchhalter, Leigh Irvine, Luis Bello-Espinosa, Khorshid Mohammad
BACKGROUND: We report the impact of implementing continuous video electroencephalography monitoring for neonates with hypoxic-ischemic encephalopathy via a protocol in the context of neonatal neuro-critical care program. METHODS: Neonates with hypoxic-ischemic encephalopathy were studied retrospectively two years before and after implementing continuous video electroencephalography for 72 hours as a care protocol. Before continuous video electroencephalography, a 60-minute routine electroencephalography was performed at the discretion of the provider...
August 3, 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27637401/the-role-of-surgical-intervention-in-traumatic-brain-injury
#11
REVIEW
Hadie Adams, Angelos G Kolias, Peter J Hutchinson
The general consensus to optimize the care for severe TBI patients is management at specialized neurotrauma centers with neurosurgical and neurocritical care support and the use of guidelines-based standardized protocols. Over the last decade, significant efforts have been made to define neurotrauma treatment guidelines. However, it is important to recognize the heterogeneity of TBI and that the "one-size-fits-all approach" may not always be appropriate for these patients. Knowledge synthesis activities in neurotrauma are important to define future research agendas...
October 2016: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27635737/mechanical-ventilation-in-neurocritical-care-patients-a-systematic-literature-review
#12
Beatrice Borsellino, Marcus J Schultz, Marcelo Gama de Abreu, Chiara Robba, Federico Bilotta
INTRODUCTION: Neurocritical care (NCC) patients often require prolonged mechanical ventilation, and they are at high risk of respiratory complications. Therefore, the potential benefit role of protective lung ventilation (PLV), which demonstrated to reduce postoperative complications in patients with acute distress respiratory syndrome, has been suggested even on NCC patients. However, PLV can increase intracranial pressure as result of permissive hypercapnia and of high airway pressures during recruitment maneuvers...
October 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27621379/w-ritchie-russell-a-b-baker-and-fred-plum-pioneers-of-ventilatory-management-in-poliomyelitis
#13
Eelco F M Wijdicks
Historically, neurologists were not involved in the day-to-day management of critically ill patients with bulbar poliomyelitis, but some were. The major contributions of 3 neurologists-W. Ritchie Russell, A.B. Baker, and Fred Plum-in the respiratory management of poliomyelitis have not been recognized. Russell's work was instrumental in identifying multiple types of poliomyelitis defined by their respiratory needs, and he advised treatment that varied from simple postural drainage to use of respirators. He participated in the development of the Radcliffe respiratory pump...
September 13, 2016: Neurology
https://www.readbyqxmd.com/read/27609187/alpha-2-agonists-for-sedation-in-mechanically-ventilated-neurocritical-care-patients-a-systematic-review-protocol
#14
Alexandre Tran, Henrietta Blinder, Brian Hutton, Shane English
BACKGROUND: Sedation is an important consideration in the care of the neurocritically ill patient. It provides anxiety and relief, facilitates procedures and nursing tasks, and minimizes intolerance of mechanical ventilation. Alpha-2 agonists such as dexmedetomidine and clonidine have been shown to be an effective alternative in the general critical care population by reducing duration of mechanical ventilation and length of stay in the intensive care unit (ICU), as compared to traditional sedative agents such as propofol or benzodiazepines...
September 8, 2016: Systematic Reviews
https://www.readbyqxmd.com/read/27605371/impact-of-practice-change-in-reducing-venous-thromboembolism-in-neurocritical-overweight-patients-2008-2014
#15
Sophie Samuel, Suhas Bajgur, Jude P Savarraj, Huimahn A Choi
Publications regarding early initiating venous thromboembolism (VTE) prophylaxis have been available since the early 1990s. These recommendations became available in current guidelines on and after 2012. The purpose of this study is to review the practice change in reducing the incidence of VTE in brain injury patients from 2008 to 2014. This was a single-center, retrospective, observational, cohort study. Data was extracted from our data base that included patients over 100 kg from January 2008 to August 2014...
September 7, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27604313/microdialysate-concentration-changes-do-not-provide-sufficient-information-to-evaluate-metabolic-effects-of-lactate-supplementation-in-brain-injured-patients
#16
Gerald A Dienel, Douglas L Rothman, Carl-Henrik Nordström
Cerebral microdialysis is a widely used clinical tool for monitoring extracellular concentrations of selected metabolites after brain injury and to guide neurocritical care. Extracellular glucose levels and lactate/pyruvate ratios have high diagnostic value because they can detect hypoglycemia and deficits in oxidative metabolism, respectively. In addition, patterns of metabolite concentrations can distinguish between ischemia and mitochondrial dysfunction, and are helpful to choose and evaluate therapy. Increased intracranial pressure can be life-threatening after brain injury, and hypertonic solutions are commonly used for pressure reduction...
September 7, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27598246/rapidly-progressive-quadriplegia-and-encephalopathy
#17
DonRaphael Wynn, Donald McCorquodale, Angela Peters, Kelsey Juster-Switlyk, Gordon Smith, Safdar Ansari
A woman aged 77 years was transferred to our neurocritical care unit for evaluation and treatment of rapidly progressive motor weakness and encephalopathy. Examination revealed an ability to follow simple commands only and abnormal movements, including myoclonus, tongue and orofacial dyskinesias, and opsoclonus. Imaging study findings were initially unremarkable, but when repeated, they demonstrated enhancement of the cauda equina nerve roots, trigeminal nerve, and pachymeninges. Cerebrospinal fluid examination revealed mildly elevated white blood cell count and protein levels...
September 6, 2016: JAMA Neurology
https://www.readbyqxmd.com/read/27576283/-acute-respiratory-distress-syndrome
#18
Elisa Estenssoro, Arnaldo Dubin
Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance...
2016: Medicina
https://www.readbyqxmd.com/read/27574545/multimodal-brain-monitoring-in-fulminant-hepatic-failure
#19
REVIEW
Fernando Mendes Paschoal, Ricardo Carvalho Nogueira, Karla De Almeida Lins Ronconi, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu
Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation...
August 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27567295/early-predictors-of-fever-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#20
Ivan Rocha Ferreira da Silva, Gabriel Rodriguez de Freitas
BACKGROUND: Fever is commonly observed in patients who have had aneurysmal subarachnoid hemorrhage (SAH), and it has been associated with the occurrence of delayed cerebral ischemia and worse outcomes in previous studies. Frequently, fever is not the result of bacterial infections, and distinction between infection-related fever and fever secondary to brain injury (also referred as central fever) can be challenging. OBJECTIVES: The current study aimed to identify risk factors on admission for the development of central fever in patients with SAH...
August 23, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
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