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ICU NEURO

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206 papers 100 to 500 followers
https://www.readbyqxmd.com/read/29880020/antiepileptic-drugs-in-critically-ill-patients
#1
REVIEW
Salia Farrokh, Pouya Tahsili-Fahadan, Eva K Ritzl, John J Lewin, Marek A Mirski
BACKGROUND: The incidence of seizures in intensive care units ranges from 3.3% to 34%. It is therefore often necessary to initiate or continue anticonvulsant drugs in this setting. When a new anticonvulsant is initiated, drug factors, such as onset of action and side effects, and patient factors, such as age, renal, and hepatic function, should be taken into account. It is important to note that the altered physiology of critically ill patients as well as pharmacological and nonpharmacological interventions such as renal replacement therapy, extracorporeal membrane oxygenation, and target temperature management may lead to therapeutic failure or toxicity...
June 7, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29875116/evidence-based-review-of-clinical-trials-in-neurocritical-care
#2
Molly McNett, Cristina Moran, Halee Johnson
Neurocritical care is a rapidly growing specialty of complex care for the critically ill patient with neurological injury. This rapid growth has led to an increase in the number of important clinical trials to guide clinical practice and evidence-based care of the critically ill patient with neurological injury. Specialty-trained critical care nurses and advanced practice providers are integral members of neurocritical care teams and must remain informed about pivotal trials shaping practice recommendations...
2018: AACN Advanced Critical Care
https://www.readbyqxmd.com/read/29651625/clinical-characteristics-and-prognosis-of-severe-anti-n-methyl-d-aspartate-receptor-encephalitis-patients
#3
Yan Zhang, Gang Liu, Mengdi Jiang, Weibi Chen, Yanbo He, Yingying Su
BACKGROUND AND PURPOSE: Data concerning the characteristics and duration of the critical manifestations, treatment response, and long-term outcomes of severe anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis patients compared to those of non-severe patients are limited. This observational study was performed to explore the clinical characteristics and long-term outcomes of severe anti-NMDAR encephalitis patients. METHODS: According to their characteristics on admission to the neurology intensive care unit, patients with anti-NMDAR encephalitis were divided into a severe group and a non-severe group...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29629926/neuroprognostication-postcardiac-arrest-translating-probabilities-to-individuals
#4
Clifton W Callaway
PURPOSE OF REVIEW: Predicting neurological recovery in patients who are comatose after cardiac arrest is an important activity during postarrest care, and this prediction can affect survival. As no early test or clinical finding perfectly predicts potential for recovery, guidelines recommend using data from multiple examinations or tests to estimate patient prognosis. RECENT FINDINGS: Studies reported accuracy of initial clinical examination, progression of clinical examination, early (<24 h) brain imaging, electroencephalography (EEG), evoked potentials, later (>24 h) brain imaging, blood markers of brain injury, and cerebral oximetry for predicting good or poor outcome...
June 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29674324/indications-for-the-performance-of-intracranial-endovascular-neurointerventional-procedures-a-scientific-statement-from-the-american-heart-association
#5
REVIEW
Clifford J Eskey, Philip M Meyers, Thanh N Nguyen, Sameer A Ansari, Mahesh Jayaraman, Cameron G McDougall, J Kevin DeMarco, William A Gray, David C Hess, Randall T Higashida, Dilip K Pandey, Constantino Peña, Hermann C Schumacher
Intracranial endovascular interventions provide effective and minimally invasive treatment of a broad spectrum of diseases. This area of expertise has continued to gain both wider application and greater depth as new and better techniques are developed and as landmark clinical studies are performed to guide their use. Some of the greatest advances since the last American Heart Association scientific statement on this topic have been made in the treatment of ischemic stroke from large intracranial vessel occlusion, with more effective devices and large randomized clinical trials showing striking therapeutic benefit...
May 22, 2018: Circulation
https://www.readbyqxmd.com/read/29661416/anaemia-and-red-blood-cell-transfusion-in-intracranial-neurosurgery-a-comprehensive-review
#6
REVIEW
A Kisilevsky, A W Gelb, M Bustillo, A M Flexman
Both anaemia and blood transfusion are associated with poor outcomes in the neurosurgical population. Based on the available literature, the optimal haemoglobin concentration for neurologically injured patients appears to be in the range of 9.0-10.0 g dl-1 , although the individual risks and benefits should be weighed. Several perioperative blood conservation strategies have been used successfully in neurosurgery, including correction of anaemia and coagulopathy, use of antifibrinolytics, and intraoperative cell salvage...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29801883/novel-minimally-invasive-multi-modality-monitoring-modalities-in-neurocritical-care
#7
REVIEW
Fawaz Al-Mufti, Brendan Smith, Megan Lander, Nitesh Damodara, Rolla Nuoman, Mohammad El-Ghanem, Naveed Kamal, Sarmad Al-Marsoummi, Basim Alzubaidi, Halla Nuoaman, Brandon Foreman, Krishna Amuluru, Chirag D Gandhi
Elevated intracranial pressure (ICP) following brain injury contributes to poor outcomes for patients, primarily by reducing the caliber of cerebral vasculature, and thereby reducing cerebral blood flow. Careful monitoring of ICP is critical in these patients in order to determine prognosis, implement treatment when ICP becomes elevated, and to judge responsiveness to treatment. Currently, the gold standard for monitoring is invasive pressure transducers, usually an intraventricular monitor, which presents significant risk of infection and hemorrhage...
July 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29850022/heat-stroke
#8
REVIEW
Toru Hifumi, Yutaka Kondo, Keiki Shimizu, Yasufumi Miyake
Background: Heat stroke is a life-threatening injury requiring neurocritical care; however, heat stroke has not been completely examined due to several possible reasons, such as no universally accepted definition or classification, and the occurrence of heat wave victims every few years. Thus, in this review, we elucidate the definition/classification, pathophysiology, and prognostic factors related to heat stroke and also summarize the results of current studies regarding the management of heat stroke, including the use of intravascular balloon catheter system, blood purification therapy, continuous electroencephalogram monitoring, and anticoagulation therapy...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29519206/the-top-ten-websites-in-critical-care-medicine-education-today
#9
Traci A Wolbrink, Lucy Rubin, Jeffrey P Burns, Barry Markovitz
INTRODUCTION: The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary. METHODS: A new assessment tool for evaluating critical care medicine education websites, the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET), was modified from existing tools...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29673823/carotid-artery-endarterectomy-versus-carotid-artery-stenting-for-restenosis-after-carotid-artery-endarterectomy-a-systematic-review-and-meta-analysis
#10
REVIEW
Pavlos Texakalidis, Stefanos Giannopoulos, Anil K Jonnalagadda, Damianos G Kokkinidis, Theofilos Machinis, John Reavey-Cantwell, Ehrin J Armstrong, Pascal Jabbour
OBJECTIVE: Carotid artery restenosis may occur after ipsilateral carotid endarterectomy (CEA). The aim of this study was to determine whether carotid artery stenting (CAS) or redo CEA is the optimal treatment for postendarterectomy carotid restenosis. METHODS: Eligible studies for meta-analysis were identified through a search of PubMed, Scopus, and Cochrane up to July 20, 2017. A meta-analysis was conducted with the use of random effects modeling. I2 was used to assess for heterogeneity...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#11
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29369063/long-term-outcome-following-decompressive-craniectomy-an-inconvenient-truth
#12
Stephen Honeybul, Kwok M Ho, Grant R Gillett
PURPOSE OF REVIEW: There is little doubt that decompressive craniectomy can reduce mortality following malignant middle cerebral infarction or severe traumatic brain injury. However, the concern has always been that the reduction in mortality comes at the cost of an increase in the number of survivors with severe neurological disability. RECENT FINDINGS: There has been a number of large multicentre randomized trials investigating surgical efficacy of the procedure...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29369064/neuro-icu-patient-disposition-optimal-venue-for-acute-needs
#13
Rafael Badenes, Chiara Robba, Fabio S Taccone, Federico Bilotta
PURPOSE OF REVIEW: This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic brain injury (TBI) patients, postoperative neurosurgical procedures and stroke]. RECENT FINDINGS: The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date there are no widely accepted international guidelines for managing these acute brain-injured patients (stroke, TBI, postneurosurgery) in the ICU...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29401173/clinical-presentation-of-autoimmune-and-viral-encephalitides
#14
Divyanshu Dubey, Michel Toledano, Andrew McKeon
PURPOSE OF REVIEW: We describe clinical and diagnostic features of various autoimmune and viral encephalitis subtypes. RECENT FINDINGS: Population-based studies have demonstrated both autoimmune and viral causes have similar prevalence and incident rates. Repertoire of autoimmune biomarkers has considerably increased with discovery of many novel neural antibodies including glial fibrillary acidic proteinα-immunoglobulin G. Similarly, with use of next generation sequencing and DNA libraries, many viral causes are being detected which would have been categorized as encephalitis of unknown cause a decade ago...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29401175/is-hemoglobin-good-for-cerebral-oxygenation-and-clinical-outcome-in-acute-brain-injury
#15
Shane W English, Lauralyn McIntyre
PURPOSE OF REVIEW: The purpose of this review is to highlight the role of hemoglobin in cerebral physiology and pathophysiology. We review the existing as well as recent evidence detailing the effects of red blood cell transfusion on cerebral oxygenation and clinical outcome. RECENT FINDINGS: Hemoglobin is a key component in oxygen delivery, and thus cerebral oxygenation. Higher hemoglobin levels and red blood cell transfusion are associated with higher cerebral oxygen delivery and decreased cerebral ischemic burden...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29517981/pain-management-in-neurocritical-care-an-update
#16
Athir Morad, Salia Farrokh, Alexander Papangelou
PURPOSE OF REVIEW: Pain management in neurocritical care is a subject often avoided because of concerns over the side-effects of analgesics and the potential to cause additional neurological injury with treatment. The sedation and hypercapnia caused by opioids have been feared to mask the neurological examination and contribute to elevations in intracranial pressure. Nevertheless, increasing attention to patient satisfaction has sparked a resurgence in pain management. As opioids have remained at the core of analgesic therapy, the increasing attention to pain has contributed to a growing epidemic of opioid dependence...
April 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29293475/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-central-nervous-system-infections
#17
Roland Nau, Jana Seele, Marija Djukic, Helmut Eiffert
PURPOSE OF REVIEW: The barriers surrounding the central nervous system (CNS) together with the emergence of multiresistant pathogens pose a therapeutic challenge for the effective treatment of CNS infections. RECENT FINDINGS: In addition to vancomycin, colistin and aminoglycosides, classically used for intrathecal injection, drug concentrations in cerebrospinal fluid after intrathecal injection of daptomycin and tigecyclin were recently studied. SUMMARY: The entry of antiinfectives into the CNS compartments is determined by the physicochemical properties of the drug and by conditions in the host...
February 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29030715/point-of-care-transcranial-doppler-by-intensivists
#18
REVIEW
Vincent Issac Lau, Robert Thomas Arntfield
In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimensional transcranial Doppler imaging of the brain have the potential to be a middle ground to bridge this gap for certain diagnoses. With the increasing availability of point-of-care ultrasound devices, coupled with the need for rapid diagnosis of deteriorating neurologic patients, intensivists may be trained to perform point-of-care transcranial Doppler at the bedside...
October 13, 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/29310136/device-closure-versus-medical-therapy-alone-for-patent-foramen-ovale-in-patients-with-cryptogenic-stroke-a-systematic-review-and-meta-analysis
#19
Rahman Shah, Mannu Nayyar, Ion S Jovin, Abdul Rashid, Beatrix R Bondy, Tai-Hwang M Fan, Michael P Flaherty, Sunil V Rao
Background: The optimal strategy for preventing recurrent stroke in patients with cryptogenic stroke and patent foramen ovale (PFO) is unknown. Purpose: To compare transcatheter PFO closure with medical therapy alone for prevention of recurrent stroke in patients with PFO and cryptogenic stroke. Data Sources: PubMed and the Cochrane Library (without language restrictions) from inception to October 2017, reference lists, and abstracts from cardiology meetings...
March 6, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29282104/association-between-continuous-hyperosmolar-therapy-and-survival-in-patients-with-traumatic-brain-injury-a-multicentre-prospective-cohort-study-and-systematic-review
#20
Karim Asehnoune, Sigismond Lasocki, Philippe Seguin, Thomas Geeraerts, Pierre François Perrigault, Claire Dahyot-Fizelier, Catherine Paugam Burtz, Fabrice Cook, Dominique Demeure Dit Latte, Raphael Cinotti, Pierre Joachim Mahe, Camille Fortuit, Romain Pirracchio, Fanny Feuillet, Véronique Sébille, Antoine Roquilly
BACKGROUND: Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT. METHODS: We included patients with TBI (Glasgow Coma Scale ≤ 12 and trauma-associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti-TC, BI-VILI and ATLANREA...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
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