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Cough neuroscience

Julian Bösel
Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest possible time is a widely accepted principle in intensive care. For this, classic extubation criteria have been established in the general critical care setting, mainly targeting pulmonary function and cooperativeness of the patient...
December 2017: Seminars in Respiratory and Critical Care Medicine
Céline Gélinas, Kathleen A Puntillo, Madalina Boitor, Mélanie Bérubé, Jane Topolovec-Vranic, Anne-Sylvie Ramelet, Aaron M Joffe, Melissa Richard-Lalonde, Francis Bernard, David L Streiner
BACKGROUND: The evidence shows that brain-injured patients express behaviours that are related to their level of consciousness (LOC), and different from other patients in the intensive care unit (ICU). Therefore, existing behavioural scales should be revised to enhance their content and validity for use in these patients. OBJECTIVES: The aim was to evaluate the content relevance of behaviours and autonomic responses for pain assessment of brain-injured ICU patients from the perspective of critical care clinicians...
November 13, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Pramod K Guru, Tarun D Singh, Swetha Pedavally, Alejandro A Rabinstein, Sara Hocker
OBJECTIVE: Posterior fossa stroke is unique in its presentation and outcomes, and mechanical ventilation is commonly used in the management of these patients. We aimed to identify predictors of extubation success in patients with posterior fossa stroke, who require mechanical ventilation. DESIGN: We included consecutive adult patients admitted to the neurosciences ICU from January 2003 to December 2012. Extubation failure was defined as re-intubation within 7 days of extubation...
August 2016: Neurocritical Care
Robert E Hoesch, Eric Lin, Mark Young, Rebecca F Gottesman, Laith Altaweel, Paul A Nyquist, Robert D Stevens
OBJECTIVE: Acute lung injury and acute respiratory distress syndrome have been reported in a significant proportion of patients with critical neurologic illness. Our aim was to identify risk factors for acute lung injury/acute respiratory distress syndrome in this population. DESIGN: Prospective, observational study. SETTING: A 22-bed, adult neurosciences critical care unit at a tertiary care hospital. PATIENTS: Primary neurologic disorder, mechanical ventilation >48 hrs...
February 2012: Critical Care Medicine
Dea Mahanes, Rose Lewis
Many studies have been published on weaning patients from mechanical ventilation, but few have addressed the unique needs of patients with neurologic impairment. Typically, neuroscience patients remain intubated because of concerns over airway protection or neuromuscular weakness. This article discusses special weaning considerations for this patient population. Neurologic-specific weaning trends from a comprehensive ventilator weaning program are also presented.
September 2004: Critical Care Nursing Clinics of North America
A D Miller, S Nonaka, J Jakus
This study was undertaken to better delineate those brain regions that are either essential or non-essential for vomiting. Fictive vomiting, identified by a characteristic pattern of respiratory nerve discharge, was induced by a combination of emetic drugs and electrical stimulation of abdominal vagal afferents in decerebrate, paralyzed cats. Regions non-essential for coordinating vomiting included the entire cerebellum, structures rostral to the medullary retrofacial nucleus, and spinal cord. Fictive coughing was also elicited following cerebellar removal but was not studied after other procedures...
June 6, 1994: Brain Research
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