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Neurocritical care

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42 papers 25 to 100 followers
https://www.readbyqxmd.com/read/28054130/posterior-reversible-encephalopathy-syndrome
#1
REVIEW
Marlene Fischer, Erich Schmutzhard
The posterior reversible encephalopathy syndrome (PRES) is a neurological disorder of (sub)acute onset characterized by varied neurological symptoms, which may include headache, impaired visual acuity or visual field deficits, disorders of consciousness, confusion, seizures, and focal neurological deficits. In a majority of patients the clinical presentation includes elevated arterial blood pressure up to hypertensive emergencies. Neuroimaging, in particular magnetic resonance imaging, frequently shows a distinctive parieto-occipital pattern with a symmetric distribution of changes reflecting vasogenic edema...
January 4, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28035993/brain-monitoring-in-critically-neurologically-impaired-patients
#2
REVIEW
Salazar Jones, Gary Schwartzbauer, Xiaofeng Jia
Assessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram...
December 27, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27965228/safety-of-continuous-peripheral-infusion-of-3-sodium-chloride-solution-in-neurocritical-care-patients
#3
G Morgan Jones, Lauren Bode, Heidi Riha, Michael J Erdman
BACKGROUND: Numerous drug information resources recommend that continuous intravenous 3% sodium chloride solution be administered via a central catheter. OBJECTIVES: To evaluate the incidence of infusion-related reactions and electrolyte abnormalities in neurocritical care patients treated with continuous intravenous infusion of 3% sodium chloride solution via a peripheral catheter. METHODS: Data on patients treated with continuous intravenous infusion of 3% sodium chloride solution at 2 academic medical centers were evaluated retrospectively to determine the administration site...
December 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27852691/medical-management-of-intracerebral-haemorrhage
#4
REVIEW
Floris H B M Schreuder, Shoichiro Sato, Catharina J M Klijn, Craig S Anderson
The global burden of intracerebral haemorrhage (ICH) is enormous. Developing evidence-based management strategies for ICH has been hampered by its diverse aetiology, high case fatality and variable cooperative organisation of medical and surgical care. Progress is being made through the conduct of collaborative multicentre studies with the large sample sizes necessary to evaluate therapies with realistically modest treatment effects. This narrative review describes the major consequences of ICH and provides evidence-based recommendations to support decision-making in medical management...
January 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27563745/baclofen-in-the-therapeutic-of-sequele-of-traumatic-brain-injury-spasticity
#5
Adán Pérez-Arredondo, Eduardo Cázares-Ramírez, Paul Carrillo-Mora, Marina Martínez-Vargas, Noemí Cárdenas-Rodríguez, Elvia Coballase-Urrutia, Radamés Alemón-Medina, Aristides Sampieri, Luz Navarro, Liliana Carmona-Aparicio
Traumatic brain injury (TBI) is an alteration in brain function, caused by an external force, which may be a hit on the skull, rapid acceleration or deceleration, penetration of an object, or shock waves from an explosion. Traumatic brain injury is a major cause of morbidity and mortality worldwide, with a high prevalence rate in pediatric patients, in which treatment options are still limited, not available at present neuroprotective drugs. Although the therapeutic management of these patients is varied and dependent on the severity of the injury, general techniques of drug types are handled, as well as physical and surgical...
November 2016: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/27815684/factors-associated-with-fatal-outcome-in-posterior-reversible-encephalopathy-syndrome-a-retrospective-analysis-of-the-berlin-pres-study
#6
Eberhard Siebert, G Bohner, T Liebig, M Endres, T G Liman
Although often reversible, fatal outcome in posterior reversible encephalopathy syndrome (PRES) is well known. However, data on predictors of PRES-associated in-hospital death are scarce. In this study, we aimed to investigate predictors of in-hospital death in a large cohort. Radiological report databases between January 1999 and February 2015 were retrospectively searched for patients with PRES. Patients were included if they met criteria for PRES after detailed investigation of clinical charts and imaging studies...
November 4, 2016: Journal of Neurology
https://www.readbyqxmd.com/read/27640182/the-critical-care-management-of-spontaneous-intracranial-hemorrhage-a-contemporary-review
#7
REVIEW
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/21242790/hypertonic-saline-versus-mannitol-for-the-treatment-of-elevated-intracranial-pressure-a-meta-analysis-of-randomized-clinical-trials
#8
COMPARATIVE STUDY
Hooman Kamel, Babak B Navi, Kazuma Nakagawa, J Claude Hemphill, Nerissa U Ko
OBJECTIVES: Randomized trials have suggested that hypertonic saline solutions may be superior to mannitol for the treatment of elevated intracranial pressure, but their impact on clinical practice has been limited, partly by their small size. We therefore combined their findings in a meta-analysis. DATA SOURCES: We searched for relevant studies in MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and ISI Web of Knowledge. STUDY SELECTION: Randomized trials were included if they directly compared equiosmolar doses of hypertonic sodium solutions to mannitol for the treatment of elevated intracranial pressure in human subjects undergoing quantitative intracranial pressure measurement...
March 2011: Critical Care Medicine
https://www.readbyqxmd.com/read/25726965/hypertonic-saline-for-the-management-of-raised-intracranial-pressure-after-severe-traumatic-brain-injury
#9
Halinder S Mangat, Roger Härtl
Hyperosmolar agents are commonly used as an initial treatment for the management of raised intracranial pressure (ICP) after severe traumatic brain injury (TBI). They have an excellent adverse-effect profile compared to other therapies, such as hyperventilation and barbiturates, which carry the risk of reducing cerebral perfusion. The hyperosmolar agent mannitol has been used for several decades to reduce raised ICP, and there is accumulating evidence from pilot studies suggesting beneficial effects of hypertonic saline (HTS) for similar purposes...
May 2015: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/18209674/equimolar-doses-of-mannitol-and-hypertonic-saline-in-the-treatment-of-increased-intracranial-pressure
#10
RANDOMIZED CONTROLLED TRIAL
Gilles Francony, Bertrand Fauvage, Dominique Falcon, Charles Canet, Henri Dilou, Pierre Lavagne, Claude Jacquot, Jean-Francois Payen
OBJECTIVE: To compare the effects of equimolar doses of 20% mannitol solution and of 7.45% hypertonic saline solution (HSS) in the treatment of patients with sustained elevated intracranial pressure (ICP). DESIGN: Parallel, randomized, controlled trial. SETTING: Two intensive care units in a university hospital. PATIENTS: A total of 20 stable patients with a sustained ICP of >20 mm Hg secondary to traumatic brain injury (n = 17) or stroke (n = 3)...
March 2008: Critical Care Medicine
https://www.readbyqxmd.com/read/25385844/prognosis-of-patients-with-bilateral-fixed-dilated-pupils-secondary-to-traumatic-extradural-or-subdural-haematoma-who-undergo-surgery-a-systematic-review-and-meta-analysis
#11
REVIEW
John Scotter, Susan Hendrickson, Hani J Marcus, Mark H Wilson
PRIMARY OBJECTIVE: To review the prognosis of patients with bilateral fixed and dilated pupils secondary to traumatic extradural (epidural) or subdural haematoma who undergo surgery. METHODS: A systematic review and meta-analysis was performed using random effects models. The Cochrane Central Register of Controlled Trials and PubMed databases were searched to identify relevant publications. Eligible studies were publications that featured patients with bilateral fixed and dilated pupils who underwent surgical evacuation of traumatic extra-axial haematoma, and reported on the rate of favourable outcome (Glasgow Outcome Score 4 or 5)...
August 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27145814/optimizing-sedation-in-patients-with-acute-brain-injury
#12
REVIEW
Mauro Oddo, Ilaria Alice Crippa, Sangeeta Mehta, David Menon, Jean-Francois Payen, Fabio Silvio Taccone, Giuseppe Citerio
Daily interruption of sedative therapy and limitation of deep sedation have been shown in several randomized trials to reduce the duration of mechanical ventilation and hospital length of stay, and to improve the outcome of critically ill patients. However, patients with severe acute brain injury (ABI; including subjects with coma after traumatic brain injury, ischaemic/haemorrhagic stroke, cardiac arrest, status epilepticus) were excluded from these studies. Therefore, whether the new paradigm of minimal sedation can be translated to the neuro-ICU (NICU) is unclear...
May 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27720246/extra-central-nervous-system-target-for-assessment-and-treatment-in-refractory-anti-n-methyl-d-aspartate-receptor-encephalitis
#13
David W Nauen
Anti-N-methyl-d-aspartate-type glutamate receptor autoimmune encephalitis can arise in the setting of ovarian teratoma and often responds to resection. When it occurs in the absence of tumor, failure to respond to treatment may be more likely, and affected patients often require intensive care. To further understand the mechanisms and potential management, we present findings from an autopsy conducted on a young woman who died of refractory autoimmune encephalitis of this type. Rituximab was administered 70 days before death, and both 37 and 14 days before death, CD19(+) lymphocytes were only 0...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/26416129/intubation-of-the-neurologically-injured-patient
#14
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/27806789/-feasibility-of-using-amplitude-integrated-electroencephalogram-to-identify-epileptic-seizures-by-pediatric-intensive-care-unit-medical-staff-independently
#15
Q Guan, S Li, X Li, H P Yang, Y Wang, X Y Liu
Objective: To evaluate the feasibility of using amplitude-integrated electroencephalogram (aEEG) to identify epileptic seizures by physicians and nurses in pediatric intensive care unit (PICU) independently. Method: Six testees (two PICU physicians versus one EEG physician and two PICU nurses versus one EEG technician) accepted a short-term training, then interpreted aEEG in a single blinded way. These aEEG recordings with synchronous VEEG monitoring were done from January 2013 to May 2015 in PICU. The testees should recognize and mark both the seizure type and the seizure duration from the two-channel recorder (C3/C4) of aEEG (short-term seizure or status epilepticus (SE))...
November 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/26261769/brain-lung-crosstalk-implications-for-neurocritical-care-patients
#16
REVIEW
Ségolène Mrozek, Jean-Michel Constantin, Thomas Geeraerts
Major pulmonary disorders may occur after brain injuries as ventilator-associated pneumonia, acute respiratory distress syndrome or neurogenic pulmonary edema. They are key points for the management of brain-injured patients because respiratory failure and mechanical ventilation seem to be a risk factor for increased mortality, poor neurological outcome and longer intensive care unit or hospital length of stay. Brain and lung strongly interact via complex pathways from the brain to the lung but also from the lung to the brain...
August 4, 2015: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26855892/neuroprotective-measures-in-children-with-traumatic-brain-injury
#17
REVIEW
Shruti Agrawal, Ricardo Garcia Branco
Traumatic brain injury (TBI) is a major cause of death and disability in children. Severe TBI is a leading cause of death and often leads to life changing disabilities in survivors. The modern management of severe TBI in children on intensive care unit focuses on preventing secondary brain injury to improve outcome. Standard neuroprotective measures are based on management of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) to optimize the cerebral blood flow and oxygenation, with the intention to avoid and minimise secondary brain injury...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26855895/respiratory-mechanics-in-brain-injury-a-review
#18
REVIEW
Antonia Koutsoukou, Maria Katsiari, Stylianos E Orfanos, Anastasia Kotanidou, Maria Daganou, Magdalini Kyriakopoulou, Nikolaos G Koulouris, Nikoletta Rovina
Several clinical and experimental studies have shown that lung injury occurs shortly after brain damage. The responsible mechanisms involve neurogenic pulmonary edema, inflammation, the harmful action of neurotransmitters, or autonomic system dysfunction. Mechanical ventilation, an essential component of life support in brain-damaged patients (BD), may be an additional traumatic factor to the already injured or susceptible to injury lungs of these patients thus worsening lung injury, in case that non lung protective ventilator settings are applied...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27601069/effect-of-early-versus-late-tracheostomy-or-prolonged-intubation-in-critically-ill-patients-with-acute-brain-injury-a-systematic-review-and-meta-analysis
#19
Victoria A McCredie, Aziz S Alali, Damon C Scales, Neill K J Adhikari, Gordon D Rubenfeld, Brian H Cuthbertson, Avery B Nathens
BACKGROUND: The optimal timing of tracheostomy placement in acutely brain-injured patients, who generally require endotracheal intubation for airway protection rather than respiratory failure, remains uncertain. We systematically reviewed trials comparing early tracheostomy to late tracheostomy or prolonged intubation in these patients. METHODS: We searched 5 databases (from inception to April 2015) to identify randomized controlled trials comparing early tracheostomy (≤10 days of intubation) with late tracheostomy (>10 days) or prolonged intubation in acutely brain-injured patients...
September 6, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27660176/guillain-barr%C3%A3-syndrome
#20
Eelco F M Wijdicks
No abstract text is available yet for this article.
October 2016: Neurocritical Care
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