In December 2019 the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society and the Neuro Anaesthesia and Critical Care Society published their joint guidelines on how to safely transfer patients with acute brain injury to the appropriate level of care. Focusing on TBI and stroke-related brain injury, this consensus document outlines both… Continue reading Joint AAGBI & NACCS Guidelines on Safe Transfer of the Brain Injured Patient
The Society for Neuroscience in Anesthesiology and Critical Care (SNACC) incoming president Dr. Deepak Sharma shares his thoughts as we approach the new year. Some valuable input to bring with us into the holidays. Read his newsletter here.
This month’s edition of Current Opinion in Anaesthesiology is replete with neuro-topics, ranging from awake craniotomy to complex spinal surgery and anaesthesia for stroke thrombectomy. Well worth a read, this collection of articles provides (often excellent) summaries of evidence and current practice in numerous fields relevant to the neuroanaesthetist.
Our Danish colleagues have recently issued updated guidelines on spinal stabilisation of adult trauma patients (open-access in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine). As expected, the evidence base is fairly limited as robust randomised studies on this topic are rare and often hard to conduct. The group does provide a strong recommendation… Continue reading New Danish Guidelines on Spinal Stabilisation in Trauma
The optimal hyperosmotic agent for treatment of intracranial hypertension following TBI has been an inexhaustible subject of debate. Scant evidence underlies these discussions despite widespread and long-standing use of both agents. In this article Anstey et al. retrospectively analysed data from 14 different centres to compare outcomes in mannitol-only and hypertonic saline-only cohorts. They excluded… Continue reading Mannitol vs. Hypertonic Saline in TBI – A Retrospective Study
SNACC’s article of the month for July is an excellent narrative review on the pharmacodynamics of vasopressors in health and in the setting of brain injury. The review is preceded by an introductory commentary by neuroscand.com contributor Dr. Riikka Takala.
The landmark 2016 ATACH II trial compared aggressive blood pressure lowering (110-139 mmHg) with standard BP-targets (140-180) in patients with spontaneous ICH, and found no difference between the groups. The main endpoints were mortality and functional neurological outcome (modified Rankin scale). The only discernible difference was a tendency towards less haematoma expansion in the intervention… Continue reading ATACH II Follow-up Subgroup Analysis: Intensive BP Reduction Reduces Expansion of Deep ICH, But No Difference in Functional Outcome