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https://www.readbyqxmd.com/read/28533303/cardiopulmonary-resuscitation-in-adults-and-children-with-mechanical-circulatory-support-a-scientific-statement-from-the-american-heart-association
#1
REVIEW
Mary Ann Peberdy, Jason A Gluck, Joseph P Ornato, Christian A Bermudez, Russell E Griffin, Vigneshwar Kasirajan, Richard E Kerber, Eldrin F Lewis, Mark S Link, Corinne Miller, Jeffrey J Teuteberg, Ravi Thiagarajan, Robert M Weiss, Brian O'Neil
Cardiac arrest in patients on mechanical support is a new phenomenon brought about by the increased use of this therapy in patients with end-stage heart failure. This American Heart Association scientific statement highlights the recognition and treatment of cardiovascular collapse or cardiopulmonary arrest in an adult or pediatric patient who has a ventricular assist device or total artificial heart. Specific, expert consensus recommendations are provided for the role of external chest compressions in such patients...
May 22, 2017: Circulation
https://www.readbyqxmd.com/read/26044255/cardiac-arrest-resuscitation-and-reperfusion
#2
REVIEW
Kaustubha D Patil, Henry R Halperin, Lance B Becker
The modern treatment of cardiac arrest is an increasingly complex medical procedure with a rapidly changing array of therapeutic approaches designed to restore life to victims of sudden death. The 2 primary goals of providing artificial circulation and defibrillation to halt ventricular fibrillation remain of paramount importance for saving lives. They have undergone significant improvements in technology and dissemination into the community subsequent to their establishment 60 years ago. The evolution of artificial circulation includes efforts to optimize manual cardiopulmonary resuscitation, external mechanical cardiopulmonary resuscitation devices designed to augment circulation, and may soon advance further into the rapid deployment of specially designed internal emergency cardiopulmonary bypass devices...
June 5, 2015: Circulation Research
https://www.readbyqxmd.com/read/28489992/arteriovenous-malformations-of-the-brain
#3
REVIEW
Robert A Solomon, E Sander Connolly
New England Journal of Medicine, Volume 376, Issue 19, Page 1859-1866, May 2017.
May 11, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28486023/red-blood-cell-transfusion-guided-by-near-infrared-spectroscopy-in-neurocritically-ill-patients-with-moderate-or-severe-anaemia
#4
Santiago Ramón Leal-Noval, Victoria Arellano-Orden, Manuel Múñoz-Gómez, Aurelio Cayuela, Antonio Marín-Caballos, María D Rincón-Ferrari, Claudio García-Alfaro, Rosario Amaya-Villar, Manuel Casado-Méndez, Reginald Dusseck, Francisco Murillo-Cabezas
In neurocritically ill patients (NCPs), the use of hemoglobin level as the sole indicator for red blood cell transfusion (RBCT) can result in under- or over-transfusion. This randomised controlled trial was conducted to ascertain whether a transcranial oxygen saturation (rSO2) threshold, as measured by near-infrared spectroscopy, reduces RBCT requirements in anemic NCPs (closed traumatic brain injury, subarachnoid or intracerebral hemorrhage), compared to a hemoglobin threshold alone. Patients with hemoglobin 70-100 g/L received RBCTs to attain an rSO2 >60% (rSO2 arm) or to maintain hemoglobin between 85 and 100 g/L (hemoglobin arm)...
May 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28409729/neuropsychological-function-after-endovascular-and-neurosurgical-treatment-of-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis
#5
Peter Egeto, R Loch Macdonald, Tisha J Ornstein, Tom A Schweizer
OBJECTIVE Subarachnoid hemorrhage (SAH) is treated with either surgical clipping or endovascular coiling, though the latter is the preferred treatment method given its more favorable functional outcomes. However, neuropsychological functioning after treatment is rarely taken into account. In this meta-analysis, the authors synthesized relevant data from the literature and compared neuropsychological functioning in patients after coiling and clipping of SAH. They hypothesized that the coiled patients would outperform the clipped patients; that group differences would be greater with higher posterior circulation rupture rates, in older patients, and in more recent publications; that group differences would be smaller with greater rates of middle cerebral artery (MCA) rupture; and that anterior communicating artery (ACoA) rupture rates would not influence effect sizes...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28384077/american-telemedicine-association-telestroke-guidelines
#6
Bart M Demaerschalk, Jill Berg, Brian W Chong, Hartmut Gross, Karin Nystrom, Opeolu Adeoye, Lee Schwamm, Lawrence Wechsler, Sallie Whitchurch
The following telestroke guidelines were developed to assist practitioners in providing assessment, diagnosis, management, and/or remote consultative support to patients exhibiting symptoms and signs consistent with an acute stroke syndrome, using telemedicine communication technologies. Although telestroke practices may include the more broad utilization of telemedicine across the entire continuum of stroke care, with some even consulting on all neurologic emergencies, this document focuses on the acute phase of stroke, including both pre- and in-hospital encounters for cerebrovascular neurological emergencies...
May 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28276064/instruction-manual-for-the-ilae-2017-operational-classification-of-seizure-types
#7
Robert S Fisher, J Helen Cross, Carol D'Souza, Jacqueline A French, Sheryl R Haut, Norimichi Higurashi, Edouard Hirsch, Floor E Jansen, Lieven Lagae, Solomon L Moshé, Jukka Peltola, Eliane Roulet Perez, Ingrid E Scheffer, Andreas Schulze-Bonhage, Ernest Somerville, Michael Sperling, Elza Márcia Yacubian, Sameer M Zuberi
This companion paper to the introduction of the International League Against Epilepsy (ILAE) 2017 classification of seizure types provides guidance on how to employ the classification. Illustration of the classification is enacted by tables, a glossary of relevant terms, mapping of old to new terms, suggested abbreviations, and examples. Basic and extended versions of the classification are available, depending on the desired degree of detail. Key signs and symptoms of seizures (semiology) are used as a basis for categories of seizures that are focal or generalized from onset or with unknown onset...
April 2017: Epilepsia
https://www.readbyqxmd.com/read/28351533/the-100-most-influential-publications-pertaining-to-intracranial-aneurysms-and-aneurysmal-subarachnoid-hemorrhage
#8
REVIEW
James Zhou, Nitin Agarwal, D Kojo Hamilton, Michael T Koltz
The study of intracranial aneurysms has grown at an astounding rate since Sir Charles Symond's association of hemorrhage within the subarachnoid space to intracranial aneurysms in 1923. These associations led to the first surgical treatment of an intracranial aneurysm with wrapping by Norman Dott in 1931, and shortly thereafter, clip ligation by Walter Dandy in 1938. Surgical outcomes were improved by the introduction of the operative microscope in the 1960s and perioperative care utilizing induced hypertension, hypovolemia, and hemodilution ("HHH therapy")...
March 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28325462/management-of-recurrent-subdural-hematomas
#9
REVIEW
Virendra R Desai, Robert A Scranton, Gavin W Britz
Subdural hematomas commonly recur after surgical evacuation, at a rate of 2% to 37%. Risk factors for recurrence can be patient related, radiologic, or surgical. Patient-related risk factors include alcoholism, seizure disorders, coagulopathy, and history of ventriculoperitoneal shunt. Radiologic factors include poor brain reexpansion postoperatively, significant subdural air, greater midline shift, heterogeneous hematomas (layered or multi-loculated), and higher-density hematomas. Surgical factors include lack of or poor postoperative drainage...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325459/natural-history-of-acute-subdural-hematoma
#10
REVIEW
Rafael A Vega, Alex B Valadka
Because published guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are based largely on case series and other weak evidence, management often must be individualized. Nonoperative management is a viable option in many cases. The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas. Close clinical and radiologic follow-up is needed, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#11
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28325463/perioperative-management-of-anticoagulation
#12
REVIEW
Daipayan Guha, R Loch Macdonald
Antiplatelet and anticoagulant drugs (antithrombotics) predispose to acute and chronic subdural hematomas. Patients on these drugs are at higher likelihood of presenting with larger hematomas and more severe neurologic deficits. Standard neurosurgical and neurocritical care of subdural hematomas involves reversal of antithrombosis preoperatively, whereas reversing antiplatelet drugs is less clear. This article highlights the spectrum of antithrombotic agents in common use, their mechanisms of action, and strategies for reversal...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/23182529/improving-intensive-care-unit-quality-using-collaborative-networks
#13
REVIEW
Sam R Watson, Damon C Scales
Collaborative networks of intensive care units can help promote a quality-improvement agenda across an entire system or region. Proposed advantages include targeting a greater number of patients, sharing of resources, and common measurement systems for audit and feedback or benchmarking. This review focuses on elements that are essential for the success and sustainability of these collaborative networks, using as examples networks in Michigan and Ontario. More research is needed to understand the mechanisms through which collaborative networks lead to improved care delivery and to demonstrate their cost-effectiveness in comparison with other approaches to system-level quality improvement...
January 2013: Critical Care Clinics
https://www.readbyqxmd.com/read/28287909/clinical-evaluation-of-a-microwave-based-device-for-detection-of-traumatic-intracranial-hemorrhage
#14
Johan Ljungqvist, Stefan Candefjord, Mikael Persson, Lars Jönsson, Thomas Skoglund, Mikael Elam
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke...
March 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27960167/intracranial-arteries-anatomy-and-collaterals
#15
REVIEW
David S Liebeskind, Louis R Caplan
Anatomy, physiology, and pathophysiology are inextricably linked in patients with intracranial atherosclerosis. Knowledge of abnormal or pathological conditions such as intracranial atherosclerosis stems from detailed recognition of the normal pattern of vascular anatomy. The vascular anatomy of the intracranial arteries, both at the level of the vessel wall and as a larger structure or conduit, is a reflection of physiology over time, from in utero stages through adult life. The unique characteristics of arteries at the base of the brain may help our understanding of atherosclerotic lesions that tend to afflict specific arterial segments...
2016: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/28243998/shunt-devices-for-neurointensivists-complications-and-management
#16
G Smith, J Pace, A Scoco, G Singh, K Kandregula, S Manjila, C Ramos-Estebanez
Cerebrospinal fluid diversion has become the mainstay treatment in hydrocephalus for over 50 years. As the number of patients with ventricular shunt systems increases, neurointensivists are becoming the first-line physicians for many of these patients. When symptoms of a shunt malfunction are suspected and access to a neurosurgeon is limited or delayed, workup and temporizing measures must be initiated. The article highlights the functional nuances, complications, and management of current programmable shunt valves and their MRI sensitivity...
February 27, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28187810/management-of-infections-associated-with-neurocritical-care
#17
REVIEW
L Rivera-Lara, W Ziai, P Nyquist
The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28244000/changes-in-cerebral-perfusion-with-induced-hypertension-in-aneurysmal-subarachnoid-hemorrhage-a-pilot-and-feasibility-study
#18
Amanda Murphy, Airton Leonardo de Oliveira Manoel, R Loch Macdonald, Andrew Baker, Ting-Yim Lee, Tom Marotta, Walter Montanera, Richard Aviv, Aditya Bharatha
BACKGROUND: The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with computed tomography perfusion (CTP) before and after IH; (2) evaluate differences in the presence of infarction and clinical outcome between patients with and without IH. METHODS: We performed a retrospective cohort analysis of 25 aneurysmal SAH patients...
February 27, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28203777/2017-infectious-diseases-society-of-america-s-clinical-practice-guidelines-for-healthcare-associated-ventriculitis-and-meningitis
#19
Allan R Tunkel, Rodrigo Hasbun, Adarsh Bhimraj, Karin Byers, Sheldon L Kaplan, W Michael Scheld, Diederik van de Beek, Thomas P Bleck, Hugh J L Garton, Joseph R Zunt
No abstract text is available yet for this article.
February 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28214798/intensive-blood-pressure-lowering-in-patients-with-acute-intracerebral-haemorrhage-clinical-outcomes-and-haemorrhage-expansion-systematic-review-and-meta-analysis-of-randomised-trials
#20
REVIEW
Gregoire Boulouis, Andrea Morotti, Joshua N Goldstein, Andreas Charidimou
INTRODUCTION: It is unclear whether intensive lowering of blood pressure (BP) at the acute phase of intracerebral haemorrhage (ICH) is beneficial. We performed a meta-analysis of randomised controlled trials (RCTs) to assess whether intensive BP lowering in patients with acute ICH is safe and effective in improving clinical outcomes. METHODS: We searched PubMed, EMBASE and the Cochrane databases for relevant RCTs and calculated pooled OR for 3-month mortality (safety outcome) and 3-month death or dependency (modified Rankin Scale (mRs) ≥3;efficacy outcome), in patients with acute ICH randomised to either intensive BP-lowering or standard BP-lowering treatment protocols...
April 2017: Journal of Neurology, Neurosurgery, and Psychiatry
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