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https://www.readbyqxmd.com/read/28929324/stress-ulcer-prophylaxis-in-neurocritical-care
#1
Jeffrey F Barletta, Alicia J Mangram, Joseph F Sucher, Victor Zach
Stress ulcer prophylaxis (SUP) with acid-suppressive drug therapy is widely utilized in critically ill patients following neurologic injury for the prevention of clinically important stress-related gastrointestinal bleeding (CIB). Data supporting SUP, however, largely originates from studies conducted during an era where practices were vastly different than what is considered routine by today's standard. This is particularly true in neurocritical care patients. In fact, the routine provision of SUP has been challenged due to an increasing prevalence of adverse drug events with acid-suppressive therapy and the perception that CIB rates are sparse...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28925974/if-you-build-it-they-will-come-initial-experience-with-a-multi-disciplinary-pediatric-neurocritical-care-follow-up-clinic
#2
Cydni N Williams, Aileen Kirby, Juan Piantino
Pediatric Neurocritical Care diagnoses account for a large proportion of intensive care admissions. Critical care survivors suffer high rates of long-term morbidity, including physical disability, cognitive impairment, and psychosocial dysfunction. To address these morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals apply to all Pediatric Neurocritical Care patients regardless of admission severity of illness...
September 19, 2017: Children
https://www.readbyqxmd.com/read/28916970/caring-for-patients-families-or-lack-of-family-in-neurocritical-care
#3
EDITORIAL
David Y Hwang
No abstract text is available yet for this article.
September 15, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913813/pharmacotherapy-pearls-for-emergency-neurological-life-support
#4
Gretchen M Brophy, Theresa Human
The appropriate use of medications during Emergency Neurological Life Support (ENLS) is essential to optimize patient care. Important considerations when choosing the appropriate agent include the patient's organ function and medication allergies, potential adverse drug effects, drug interactions and critical illness and aging pathophysiologic changes. Critical medications used during ENLS include hyperosmolar therapy, anticonvulsants, antithrombotics, anticoagulant reversal and hemostatic agents, anti-shivering agents, neuromuscular blockers, antihypertensive agents, sedatives, vasopressors and inotropes, and antimicrobials...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913811/emergency-neurological-life-support-third-edition-updates-in-the-approach-to-early-management-of-a-neurological-emergency
#5
Kristine H O'Phelan, Chad M Miller
Emergency Neurologic Life Support (ENLS) is an educational program designed to provide users advisory instructions regarding management for the first few hours of a neurologic emergency. The content of the course is divided into 14 modules, each addressing a distinct category of neurological injury. The course is appropriate for practitioners and providers from various backgrounds who work in environments of variable medical complexity. The focus of ENLS is centered on a standardized treatment algorithm, checklists, to guide early patient care, and a structured format for communication of findings and concerns to other healthcare professionals...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#6
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28892887/active-surveillance-of-health-care-associated-infections-in-neurosurgical-patients
#7
Reshu Agarwal, Sarita Mohapatra, Girija Prasad Rath, Arti Kapil
INTRODUCTION: Health Care Associated Infections (HCAI) are frequent complications in neurosurgery. There is limited data available on the incidence and burden of HCAI in neurosurgical patients of Southeast Asian region. AIM: To identify various HCAIs, associated aetiological agents and their antimicrobial susceptibility pattern among the patients admitted in the neurosurgery unit. MATERIALS AND METHODS: An observational prospective study was carried out for three months duration on all neurosurgical patients admitted to a tertiary-care center...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28836877/management-of-hyperglycemia-in-the-neurosurgery-patient
#8
Rene Daniel, Satya Villuri, Kevin Furlong
Hyperglycemia is associated with adverse outcomes in patients who are candidates for or underwent neurosurgical procedures. Specific concerns and settings that relate to these patients are preoperative glycemic control, intraoperative control, management in the neurological intensive care unit (NICU), and postoperative control. In each of these settings, physicians have to ensure appropriate glycemic control to prevent or minimize adverse events. The glycemic control is usually managed by a neurohospitalist in co-management with the neurosurgery team pre- and post-operatively, and by the neurocritical care team in the setting of NICU...
August 30, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28817501/nurses-perceptions-of-a-novel-protocol-addressing-uniform-periods-of-minimum-assessment-times
#9
Annamma Steaphen, DaiWai M Olson, Sonja E Stutzman
AIMS AND OBJECTIVES: This quality improvement project aimed to understand the impact of a quiet time protocol on nurses and patients in the neurocritical care unit (NCCU) by comparing pretest and posttest outcomes, taking decibel readings, and abstracting chart information. BACKGROUND: Sleep is essential for maintaining a healthy life. Patients in the NCCU often do not get adequate amounts of sleep. Quiet time studies have focused on implementing periods of reduced noise levels to improve patient sleep...
August 16, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#10
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28811941/seizure-associated-takotsubo-syndrome-a-rare-combination
#11
Htay Htay Kyi, Nour Aljariri Alhesan, Sunil Upadhaya, Samer Al Hadidi
Takotsubo cardiomyopathy (TC) is increasingly recognized in neurocritical care population especially in postmenopausal females. We are presenting a 61-year-old African American female with past medical history of epilepsy, bipolar disorder, and hypertension who presented with multiple episodes of seizures due to noncompliance with antiepileptic medications. She was on telemetry which showed ST alarm. Electrocardiogram (ECG) was ordered and showed ST elevation in anterolateral leads and troponins were positive...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28799870/vitamin-d-status-and-3-month-glasgow-outcome-scale-scores-in-patients-in-neurocritical-care-prospective-analysis-of-497-patients
#12
Jian Guan, Michael Karsy, Andrea A Brock, Ilyas M Eli, Gabrielle M Manton, Holly K Ledyard, Gregory W J Hawryluk, Min S Park
OBJECTIVE Vitamin D deficiency has been associated with a variety of negative outcomes in critically ill patients, but little focused study on the effects of hypovitaminosis D has been performed in the neurocritical care population. In this study, the authors examined the effect of vitamin D deficiency on 3-month outcomes after discharge from a neurocritical care unit (NCCU). METHODS The authors prospectively analyzed 25-hydroxy vitamin D levels in patients admitted to the NCCU of a quaternary care center over a 6-month period...
August 11, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28789958/diagnosis-of-ventriculostomy-related-infection-is-cerebrospinal-fluid-lactate-measurement-a-useful-tool
#13
Pedro Grille, Federico Verga, Alberto Biestro
OBJECTIVE: To evaluate the value of CSF lactate (LCSF) for the diagnosis of ventriculostomy related infections (VRI), and compare it with other CSF markers. METHODS: Prospective study of neurocritical patients admitted to Maciel Hospital and Clinicas Hospital ICUs in which an external ventricular drain (EVD) was inserted. In patients with clinical suspicion of VRI, a CSF sample was obtained through the EVD for CSF culture and markers analysis (glucose, protein, lactate and leukocytes)...
August 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28749123/-infectious-complications-related-to-external-ventricular-shunt-incidence-and-risk-factors
#14
L López-Amor, L Viña, L Martín, C Calleja, R Rodríguez-García, I Astola, L Forcelledo, L Álvarez-García, C Díaz-Gómez, J Fernández-Domínguez, F Vázquez, D Escudero
OBJECTIVE: Infectious complications related to external ventricular shunt (ICREVS) are a main problem in neurocritical intensive care units (ICU). The aim of the review is to assess the incidence of ICREVS and to analyse factors involved. METHODS: Retrospective analysis, adult polyvalent ICU in a third level reference hospital. Patients carrying external ventricular shunt (DVE) were included. Those patients with central nervous system infection diagnosed prior DVE placement were excluded...
July 25, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28746528/simple-motor-tasks-independently-predict-extubation-failure-in-critically-ill-neurological-patients
#15
Fernanda Machado Kutchak, Marcelo de Mello Rieder, Josué Almeida Victorino, Carla Meneguzzi, Karla Poersch, Luiz Alberto Forgiarini, Marino Muxfeldt Bianchin
Objective: To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. Methods: This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#16
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28742869/ultrasound-non-invasive-measurement-of-intracranial-pressure-in-neurointensive-care-a-prospective-observational-study
#17
COMPARATIVE STUDY
Chiara Robba, Danilo Cardim, Tamara Tajsic, Justine Pietersen, Michael Bulman, Joseph Donnelly, Andrea Lavinio, Arun Gupta, David K Menon, Peter J A Hutchinson, Marek Czosnyka
BACKGROUND: The invasive nature of the current methods for monitoring of intracranial pressure (ICP) has prevented their use in many clinical situations. Several attempts have been made to develop methods to monitor ICP non-invasively. The aim of this study is to assess the relationship between ultrasound-based non-invasive ICP (nICP) and invasive ICP measurement in neurocritical care patients. METHODS AND FINDINGS: This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28713493/a-new-strategy-in-neurocritical-care-nurse-continuing-stroke-education-a-hybrid-simulation-pilot-study
#18
Christopher Ryan Newey, Robert Bell, Melody Burks, Premkumar Nattanmai
INTRODUCTION: High-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation - a combination of lecture and high-fidelity manikin - in the education of neurosciences nurses, involved in care of neurocritical care patients. METHODS: Neurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28685395/what-families-need-and-physicians-deliver-contrasting-communication-preferences-between-surrogate-decision-makers-and-physicians-during-outcome-prognostication-in-critically-ill-tbi-patients
#19
Thomas Quinn, Jesse Moskowitz, Muhammad W Khan, Lori Shutter, Robert Goldberg, Nananda Col, Kathleen M Mazor, Susanne Muehlschlegel
BACKGROUND: Surrogate decision-makers ("surrogates") and physicians of incapacitated patients have different views of prognosis and how it should be communicated, but this has not been investigated in neurocritically ill patients. We examined surrogates' communication preferences and physicians' practices during the outcome prognostication for critically ill traumatic brain injury (ciTBI) patients in two level-1 trauma centers and seven academic medical centers in the USA. METHODS: We used qualitative content analysis and descriptive statistics of transcribed interviews to identify themes in surrogates (n = 16) and physicians (n = 20)...
July 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28675112/the-relationship-of-paranasal-sinus-opacification-to-hospital-acquired-pneumonia-in-the-neurologic-intensive-care-unit-patient
#20
Phillip Huyett, Nicholas R Rowan, Berrylin J Ferguson, Stella Lee, Eric W Wang
BACKGROUND: The association between intensive care unit (ICU) sinusitis and the development of lower airway infections remains unclear. The objective of this study was to determine the correlation between the development of radiographic sinus opacification and pneumonia in the neurologic ICU setting. METHODS: A retrospective review of head computed tomography or magnetic resonance imaging of 612 patients admitted to the neurocritical care unit at a tertiary care center from April 2013 through April 2014 was performed...
January 1, 2017: Journal of Intensive Care Medicine
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