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https://www.readbyqxmd.com/read/28844205/ultrasound-guided-central-venous-catheter-placement-a-structured-review-and-recommendations-for-clinical-practice
#1
REVIEW
Bernd Saugel, Thomas W L Scheeren, Jean-Louis Teboul
The use of ultrasound (US) has been proposed to reduce the number of complications and to increase the safety and quality of central venous catheter (CVC) placement. In this review, we describe the rationale for the use of US during CVC placement, the basic principles of this technique, and the current evidence and existing guidelines for its use. In addition, we recommend a structured approach for US-guided central venous access for clinical practice. Static and real-time US can be used to visualize the anatomy and patency of the target vein in a short-axis and a long-axis view...
August 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28663521/intra-arterial-vasodilators-for-vasospasm-following-aneurysmal-subarachnoid-hemorrhage-a-meta-analysis
#2
Anand Venkatraman, Ayaz M Khawaja, Sahil Gupta, Shalaka Hardas, John P Deveikis, Mark R Harrigan, Gyanendra Kumar
OBJECTIVE: The efficacy of intra-arterial vasodilators (IADs) for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) remains debatable. The objective of this meta-analysis was to pool estimates of angiographic and neurological response, clinical outcome, and mortality following treatment of vasospasm with IADs. METHODS: We searched PubMed, Embase, Scopus, Clinicaltrials.gov, Cochrane database, and CINAHL in December 2015 and August 2016...
June 29, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28899932/utility-of-perfusion-imaging-in-acute-stroke-treatment-a-systematic-review-and-meta-analysis
#3
REVIEW
Won Hyung A Ryu, Michael B Avery, Navjit Dharampal, Isabel E Allen, Steven W Hetts
BACKGROUND: Variability in imaging protocols and techniques has resulted in a lack of consensus regarding the incorporation of perfusion imaging into stroke triage and treatment. The objective of our study was to evaluate the available scientific evidence regarding the utility of perfusion imaging in determining treatment eligibility in patients with acute stroke and in predicting their clinical outcome. METHODS: We performed a systematic review of the literature using PubMed, Web of Science, and Cochrane Library focusing on themes of medical imaging, stroke, treatment, and outcome (CRD42016037817)...
October 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28826581/uncommon-causes-of-cerebral-microbleeds
#4
REVIEW
Nariman Noorbakhsh-Sabet, Varun Chandi Pulakanti, Ramin Zand
BACKGROUND: Cerebral microbleeds (CMBs) are small and round perivascular hemosiderin depositions detectable by gradient echo sequences or susceptibility-weighted imaging. Cerebral microbleeds are common among patients with hypertension, cerebral ischemia, or cerebral amyloid angiopathy. In this article, we describe uncommon causes of CMBs. METHODS: We searched Pubmed with the keyword CMBs for relevant studies and looked for different uncommon causes of CMBs. RESULTS: CMBs have several uncommon etiologies including posterior reversible encephalopathy syndrome, infective endocarditis, brain radiation therapy, cocaine abuse, thrombotic thrombocytopenic purpura, traumatic brain injury, intravascular lymphomatosis or proliferating angio-endotheliomatosis, moyamoya disease, sickle cell anemia/β-thalassemia, cerebral autosomal dominant arteriopathy subcortical infarcts, and leukoencephalopathy (CADASIL), genetic syndromes, or obstructive sleep apnea...
August 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/26416129/intubation-of-the-neurologically-injured-patient
#5
REVIEW
Joshua Bucher, Alex Koyfman
BACKGROUND: Intubation of the neurologically injured patient is a critical procedure that must be done in a manner to prevent further neurologic injury. Although many different medications and techniques have been used to meet specific needs, there is little to no evidence to support many claims. OBJECTIVE: To review the literature regarding important topics relating to intubating patients with neurologic injury. DISCUSSION: Airway management requires ideal preoxygenation and airway maneuvers to minimize manipulation of the larynx and to maximize first-pass success...
December 2015: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#6
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28886841/identification-and-quantification-of-patent-foramen-ovale-mediated-shunts-echocardiography-and-transcranial-doppler
#7
REVIEW
Ahmed N Mahmoud, Islam Y Elgendy, Nayan Agarwal, Jonathan M Tobis, Mohammad Khalid Mojadidi
Once deemed benign, patent foramen ovale (PFO)-mediated right-to-left shunting has now been linked to stroke, migraine, and hypoxemia. Contrast transesophageal echocardiography is considered the standard technique for identifying a PFO, allowing visualization of the atrial septal anatomy and differentiation from non-PFO right-to-left shunts. Transthoracic echocardiography is the most common method for PFO imaging, being cost-effective, but has the lowest sensitivity. Transcranial Doppler is highly sensitive but is unable to differentiate cardiac from pulmonary shunts; it is the best method to quantitate shunt severity, being more sensitive than transthoracic or transesophageal echocardiography so is our preferred screening method for PFO...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28880397/transcranial-doppler-a-stethoscope-for-the-brain-neurocritical-care-use
#8
REVIEW
Chiara Robba, Danilo Cardim, Mypinder Sekhon, Karol Budohoski, Marek Czosnyka
Transcranial Doppler (TCD) ultrasonography is a noninvasive bedside monitoring technique that can evaluate cerebral blood flow hemodynamics in the intracranial arterial vasculature. TCD allows assessment of linear cerebral blood flow velocity, with a high temporal resolution and is inexpensive, reproducible, and portable. The aim of this review is to provide an overview of the most commonly used TCD derived signals and measurements used commonly in neurocritical care. We describe both basic (flow velocity, pulsatility index) and advanced concepts, including critical closing pressure, wall tension, autoregulation, noninvasive intracranial pressure, brain compliance, and cerebrovascular time constant; we also describe the clinical applications of TCD to highlight their utility in the diagnosis and monitoring of cerebrovascular diseases as the "stethoscope for the brain...
September 7, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28808153/history-of-aneurysmal-spontaneous-subarachnoid-hemorrhage
#9
REVIEW
Kristijonas Milinis, Ankur Thapar, Kevin O'Neill, Alun Huw Davies
No abstract text is available yet for this article.
August 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28743791/imaging-in-acute-ischaemic-stroke-pearls-and-pitfalls
#10
REVIEW
James Caldwell, Manraj K S Heran, Ben McGuinness, P Alan Barber
Prompt and accurate diagnosis is the foundation of acute ischaemic stroke care. Multiple positive endovascular thrombectomy trials in ischaemic stroke patients with large vessel occlusions have further emphasised this but also added complexity to treatment decisions. CT angiography is now routine for patients who present with an acute stroke syndrome around the world. Members of the neurology and stroke teams (rather than radiologists) are often the first doctors to lay eyes on the CT images and are best equipped to integrate the clinical picture with the imaging findings...
July 25, 2017: Practical Neurology
https://www.readbyqxmd.com/read/27223148/clinical-practice-cryptogenic-stroke
#11
REVIEW
Jeffrey L Saver
No abstract text is available yet for this article.
May 26, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27637674/spontaneous-subarachnoid-haemorrhage
#12
REVIEW
R Loch Macdonald, Tom A Schweizer
Subarachnoid haemorrhage is an uncommon and severe subtype of stroke affecting patients at a mean age of 55 years, leading to loss of many years of productive life. The rupture of an intracranial aneurysm is the underlining cause in 85% of cases. Survival from aneurysmal subarachnoid haemorrhage has increased by 17% in the past few decades, probably because of better diagnosis, early aneurysm repair, prescription of nimodipine, and advanced intensive care support. Nevertheless, survivors commonly have cognitive impairments, which in turn affect patients' daily functionality, working capacity, and quality of life...
February 11, 2017: Lancet
https://www.readbyqxmd.com/read/28723321/subarachnoid-hemorrhage
#13
REVIEW
Michael T Lawton, G Edward Vates
New England Journal of Medicine, Volume 377, Issue 3, Page 257-266, July 2017.
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#14
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao2/Fio2 < 150 mm Hg (ie, severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4 to 8 mL/kg predicted body weight (PBW), with plateau pressure (Pplat) ≤ 30 cm H2O, and initial positive end-expiratory pressure (PEEP) of 10 to 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 to 3 cm provided that Pplat remains ≤ 30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28601141/neuropsychiatric-aspects-of-infectious-diseases-an-update
#15
REVIEW
Sahil Munjal, Stephen J Ferrando, Zachary Freyberg
Among the critically ill, infectious diseases can play a significant role in the etiology of neuropsychiatric disturbances. All critical care physicians are familiar with delirium as a secondary complication of systemic infection. This article focuses on key infectious diseases that commonly and directly produce neuropsychiatric symptoms, including direct infection of the central nervous system, human immunodeficiency virus infection, and AIDS.
July 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28816118/paroxysmal-sympathetic-hyperactivity-the-storm-after-acute-brain-injury
#16
REVIEW
Geert Meyfroidt, Ian J Baguley, David K Menon
A substantial minority of patients who survive an acquired brain injury develop a state of sympathetic hyperactivity that can persist for weeks or months, consisting of periodic episodes of increased heart rate and blood pressure, sweating, hyperthermia, and motor posturing, often in response to external stimuli. The unifying term for the syndrome-paroxysmal sympathetic hyperactivity (PSH)-and clear diagnostic criteria defined by expert consensus were only recently established. PSH has predominantly been described after traumatic brain injury (TBI), in which it is associated with worse outcomes...
September 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28814457/direct-oral-anticoagulant-vs-vitamin-k-antagonist-related-nontraumatic-intracerebral-hemorrhage
#17
REVIEW
Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis Varelas, Aristeidis H Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W Alexandrov, Panayiotis Mitsias, Andrei V Alexandrov
OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF). METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH...
September 12, 2017: Neurology
https://www.readbyqxmd.com/read/28795958/diffusion-tensor-tractography-for-decompressive-operation-decisions-in-patients-with-intracerebral-hemorrhage
#18
Sungho Jang, Chulhoon Chang, Jonghoon Kim, Soyoung Kwak
No abstract text is available yet for this article.
August 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#19
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28548107/current-controversies-in-brain-death-determination
#20
REVIEW
Ariane Lewis, David Greer
Although the concept of brain death is accepted by the majority of physicians, lawyers, ethicists and society at large, controversies about determination of death by neurological criteria persist, and often reach the public eye. In this article, we examine four prominent controversial brain death cases from 2013-2016. We review current controversies, including protocol variability, recognition of the American Academy of Neurology (AAN) criteria for brain death as an accepted medical standard, and management of objections to discontinuation of organ support after determination of brain death...
August 2017: Nature Reviews. Neurology
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