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ICU NEURO

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126 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28207600/advancements-in-the-critical-care-management-of-status-epilepticus
#1
Andrew Bauerschmidt, Andrew Martin, Jan Claassen
PURPOSE OF REVIEW: Status epilepticus has a high morbidity and mortality. There are little definitive data to guide management; however, new recent data continue to improve understanding of management options of status epilepticus. This review examines recent advancements regarding the critical care management of status epilepticus. RECENT FINDINGS: Recent studies support the initial treatment of status epilepticus with early and aggressive benzodiazepine dosing...
February 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28207602/spreading-depolarization-monitoring-in-neurocritical-care-of-acute-brain-injury
#2
Jed A Hartings
PURPOSE OF REVIEW: Spreading depolarizations are unique in being discrete pathologic entities that are well characterized experimentally and also occur commonly in patients with substantial acute brain injury. Here, we review essential concepts in depolarization monitoring, highlighting its clinical significance, interpretation, and future potential. RECENT FINDINGS: Cortical lesion development in diverse animal models is mediated by tissue waves of mass spreading depolarization that cause the toxic loss of ion homeostasis and limit energy substrate supply through associated vasoconstriction...
February 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28203777/2017-infectious-diseases-society-of-america-s-clinical-practice-guidelines-for-healthcare-associated-ventriculitis-and-meningitis
#3
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/28118219/viral-meningitis-current-issues-in-diagnosis-and-treatment
#4
Fiona McGill, Michael J Griffiths, Tom Solomon
PURPOSE OF REVIEW: The purpose of this review is to give an overview of viral meningitis and then focus in on some of the areas of uncertainty in diagnostics, treatment and outcome. RECENT FINDINGS: Bacterial meningitis has been declining in incidence over recent years. Over a similar time period molecular diagnostics have increasingly been used. Because of both of these developments viral meningitis is becoming relatively more important. However, there are still many unanswered questions...
January 23, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28169856/postinterventional-critical-care-management-of-aneurysmal-subarachnoid-hemorrhage
#5
Sudhir Datar, Alejandro A Rabinstein
PURPOSE OF REVIEW: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28169857/intersection-of-prognosis-and-palliation-in-neurocritical-care
#6
Michael Rubin, Jordan Bonomo, J Claude Hemphill
PURPOSE OF REVIEW: Difficult discussions regarding end-of-life care are common in neurocritical care. Because of a patient's neurological impairment, decisions regarding continuing or limiting aggressive care must often be made by patients' families in conjunction with medical providers. This review provides perspective on three major aspects of this circumstance: prognostication, family-physician discussions, and determination of death (specifically as it impacts on organ donation). RECENT FINDINGS: Numerous studies have now demonstrated that prediction models developed from populations of brain-injured patients may be misleading when applied to individual patients...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28169858/central-nervous-system-infections-in-immunocompromised-patients
#7
Romain Sonneville, Eric Magalhaes, Geert Meyfroidt
PURPOSE OF REVIEW: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions. RECENT FINDINGS: Immunocompromised patients presenting with new neurological symptoms should always be suspected of a CNS infection. These infections carry a poor prognosis, especially if intracranial hypertension, severely altered mental status or seizures are present...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27941370/meta-analysis-of-therapeutic-hypothermia-for-traumatic-brain-injury-in-adult-and-pediatric-patients
#8
Ellie M Crompton, Irina Lubomirova, Ioana Cotlarciuc, Thang S Han, Sapna D Sharma, Pankaj Sharma
OBJECTIVE: Therapeutic hypothermia has been used to attenuate the effects of traumatic brain injuries. However, the required degree of hypothermia, length of its use, and its timing are uncertain. We undertook a comprehensive meta-analysis to quantify benefits of hypothermia therapy for traumatic brain injuries in adults and children by analyzing mortality rates, neurologic outcomes, and adverse effects. DATA SOURCES: Electronic databases PubMed, Google Scholar, Web of Science, Cochrane Central Register of Controlled Trials, and ClinicalTrials...
December 9, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/28085682/prophylaxis-of-venous-thrombosis-in-neurocritical-care-patients-an-executive-summary-of-evidence-based-guidelines-a-statement-for-healthcare-professionals-from-the-neurocritical-care-society-and-society-of-critical-care-medicine
#9
Paul Nyquist, Draga Jichici, Cynthia Bautista, Joseph Burns, Sanjeev Chhangani, Michele DeFilippis, Fernando D Goldenberg, Keri Kim, Xi Liu-DeRyke, William Mack, Kim Meyer
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28118848/the-association-of-findings-on-brain-computed-tomography-with-neurologic-outcomes-following-extracorporeal-cardiopulmonary-resuscitation
#10
Jeong-Am Ryu, Chi Ryang Chung, Yang Hyun Cho, Kiick Sung, Gee Young Suh, Taek Kyu Park, Young Bin Song, Joo-Yong Hahn, Jin-Ho Choi, Hyeon-Cheol Gwon, Seung-Hyuk Choi, Jeong Hoon Yang
BACKGROUND: Limited data are available on imaging predictors of neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). We investigated the association of initial brain computed tomography (CT) findings with neurological outcomes following ECPR. METHODS: Between February 2005 and December 2015, a total of 42 patients who underwent brain CT scans within 48 h after ECPR were analyzed. Loss of the boundary between gray matter and white matter (LOB) or cortical sulcal effacement (SE), gray-to-white matter ratio (GWR), and optic nerve sheath diameter (ONSD) were measured on initial brain CT...
January 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28157821/blood-pressure-control-for-acute-severe-ischemic-and-hemorrhagic-stroke
#11
Julian Bösel
PURPOSE OF REVIEW: Severe ischemic or hemorrhagic stroke is a devastating cerebrovascular disease often demanding critical care. Optimal management of blood pressure (BP) in the acute phase is controversial. The purpose of this review is to display insights from recent studies on BP control in both conditions. RECENT FINDINGS: BP control in acute ischemic stroke has recently been investigated with regard to endovascular recanalizing therapies. Decreases from baseline BP and hypotension during the intervention have been found detrimental...
February 2, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28157822/intracranial-pressure-management-in-patients-with-traumatic-brain-injury-an-update
#12
Nino Stocchetti, Tommaso Zoerle, Marco Carbonara
PURPOSE OF REVIEW: Intracranial pressure (ICP) monitoring and treatment is central in the management of traumatic brain injury. Despite 4 decades of clinical use, several aspects remain controversial, including the indications for ICP and treatment options. RECENT FINDINGS: Two major trials tested surgical decompression and mild hypothermia as treatments for high ICP. Both were rigorous, randomized, multicenter studies, with different designs. Decompression was tested for ICP refractory to conventional treatment, whereas hypothermia was offered as an alternative to conventional medical therapy...
February 2, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27968912/decompressive-craniectomy-for-severe-middle-cerebral-artery-infarction-a-meta-analysis-of-randomised-controlled-trials
#13
Yuping Li, Mengzhuo Hou, Guangyu Lu, Natalia Ciccone, Lun Dong, Zhengcun Yan, Chen Cheng, Xingdong Wang, Hengzhu Zhang
BACKGROUND: Severe middle cerebral artery infarction is defined as an acute infarction in the entire middle cerebral artery territory. Several case series have indicated that decompressive hemicraniectomy for severe middle cerebral artery infarction is lifesaving. However, data concerning the long-term functional outcome are insufficient. We did a systematic review and meta-analysis to assess the efficacy of decompressive hemicraniectomy for patients with severe middle cerebral artery infarction...
October 2016: Lancet
https://www.readbyqxmd.com/read/27894490/traumatic-brain-injury-advances
#14
REVIEW
Deborah M Stein, Cristina B Feather, Lena M Napolitano
There have been many recent advances in the management of traumatic brain injury (TBI). Research regarding established and novel therapies is ongoing. Future research must not only focus on development of new strategies but determine the long-term benefits or disadvantages of current strategies. In addition, the impact of these advances on varying severities of brain injury must not be ignored. It is hoped that future research strategies in TBI will prioritize large-scale trials using common data elements to develop large registries and databases, and leverage international collaborations...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27870576/airway-management-strategies-for-brain-injured-patients-meeting-standard-criteria-to-consider-extubation-a-prospective-cohort-study
#15
Victoria A McCredie, Niall D Ferguson, Ruxandra L Pinto, Neill K J Adhikari, Robert A Fowler, Martin G Chapman, Althea Burrell, Andrew J Baker, Deborah J Cook, Maureen O Meade, Damon C Scales
RATIONALE: Patients with acute brain injury are frequently capable of breathing spontaneously with minimal ventilatory support despite persistent neurological impairment. OBJECTIVES: We sought to describe factors associated with extubation timing, success, and primary tracheostomy in these patients. METHODS: We conducted a prospective multicenter observational cohort study in three academic hospitals in Toronto, Canada. Consecutive brain-injured adults receiving mechanical ventilation for at least 24 hours in three intensive care units were screened by study personnel daily for extubation consideration criteria...
January 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27848125/the-effect-of-positive-end-expiratory-pressure-on-intracranial-pressure-and-cerebral-hemodynamics
#16
Myles D Boone, Sayuri P Jinadasa, Ariel Mueller, Shahzad Shaefi, Ekkehard M Kasper, Khalid A Hanafy, Brian P O'Gara, Daniel S Talmor
BACKGROUND: Lung protective ventilation has not been evaluated in patients with brain injury. It is unclear whether applying positive end-expiratory pressure (PEEP) adversely affects intracranial pressure (ICP) and cerebral perfusion pressure (CPP). We aimed to evaluate the effect of PEEP on ICP and CPP in a large population of patients with acute brain injury and varying categories of acute lung injury, defined by PaO2/FiO2. METHOD: Retrospective data were collected from 341 patients with severe acute brain injury admitted to the ICU between 2008 and 2015...
November 15, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27844464/the-safety-and-effectiveness-of-intravenous-lacosamide-for-refractory-status-epilepticus-in-the-critically-ill
#17
C R Newey, N M Le, C Ahrens, P Sahota, S Hantus
BACKGROUND: Status epilepticus (SE) often does not respond to initial treatment. A second-line agent with a less established safety and efficacy profile is then required. This study examined the safety of intravenous (IV) lacosamide (LCM) in a critically ill population and obtained an estimate of effectiveness in patients with refractory SE on continuous video EEG monitoring (cEEG). METHODS: Retrospective review of critically ill patients in SE on cEEG treated with IV LCM from June 2009 to April 2011...
November 14, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27837689/neurogenic-stunned-myocardium-in-subarachnoid-hemorrhage
#18
REVIEW
Ali Kerro, Timothy Woods, Jason J Chang
"Stunned myocardium," characterized by reversible left ventricular dysfunction, was first described via animal models using transient coronary artery occlusion. However, this phenomenon has also been noted with neurologic pathologies and collectively been labeled "neurogenic stunned myocardium" (NSM). Neurogenic stunned myocardium resulting from subarachnoid hemorrhage (SAH) is a challenging pathology due to its diagnostic uncertainty. Traditional diagnostic criteria for NSM after SAH focus on electrocardiographic and echocardiographic abnormalities and troponemia...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27829714/seizures-just-the-tip-of-the-iceberg-critical-care-management-of-super-refractory-status-epilepticus
#19
REVIEW
Karen Ruby Lionel, Ajay Prasad Hrishi
Super-refractory status epilepticus (SRSE) is defined as status epilepticus (SE) that continues or recurs 24 h or more after the onset of anesthetic therapy, including those cases where SE recurs on the reduction or withdrawal of anesthesia. Although SRSE is a rare clinical problem, it is associated with high mortality and morbidity rates. This article reviews the treatment approaches and the systemic complications commonly encountered in patients with SRSE. As evident in our search of literature, therapy for SRSE and its complications have been based on clinical reports and expert opinions since there is a lack of controlled and randomized trials...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27828809/epidemiology-diagnosis-and-treatment-of-brain-abscesses
#20
Matthijs C Brouwer, Diederik van de Beek
PURPOSE OF REVIEW: This article describes the epidemiology, diagnosis, and treatment of brain abscesses focusing on studies published in the past 2 years. RECENT FINDINGS: In the recent literature, advances have been made in describing the disease, ancillary investigations, and treatment, mostly by combining previously available literature in meta-analyses. These studies identified Staphylococcus and Streptococcus species as the most frequent cause of brain abscess...
February 2017: Current Opinion in Infectious Diseases
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