Acute Cerebrovascular Conditions · European Guidelines · Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · Traumatic Brain Injury

Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Just published: the European Society of Intensive Care Medicine´s consensus document on fluid administration in the NICU. It covers all manner of neurocritical conditions and sums up the available evidence for various fluid therapy approaches. As expected there are few recommendations that aren´t already well established and by now fairly uncontroversial (multimodal monitoring, avoiding colloids,… Continue reading Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Haemodynamics · Neurocritical Care · Neurotrauma · Traumatic Brain Injury

Another Trial Suggesting Beta-blockers Are Beneficial in TBI: Time for an RCT!

We covered the subject of beta-blockade in traumatic brain injury last autumn in this article, where we summarised the increasing evidence that it seems to improve survival. A recently published trial (free full text) in the Journal of Trauma and Acute Care Surgery adds further credence to the role of beta-blockers in this patient group. This… Continue reading Another Trial Suggesting Beta-blockers Are Beneficial in TBI: Time for an RCT!

Neurocritical Care · Neuroprotection · Neurotrauma · Traumatic Brain Injury

Lancet Neurology – Special Issue Dedicated to TBI

I realise that this is old news by now, but I´ve somehow neglected to put out this excellent collection of articles on NeuroScand. The November issue of Lancet Neurology is dedicated in its entirety to traumatic brain injury and features a number of inspiring and thought-provoking editorials. Essential reading for the neurotrauma enthusiast.

Analgaesia · Cervical Spine Surgery · Neuroanaesthesia · Perioperative Management · Thoracolumbar Spine Surgery

Gabapentin and Spinal Surgery – a Meta-analysis

Christmas and New Years is usually fairly dormant in terms of publications, but a few worth mentioning have surfaced. This recent meta-analysis of gabapentin as an analgaesic adjunct in spinal surgery was published in Pain Physician by Han et al. The group included 10 trials, covering 827 patients, and found significantly reduced postoperative morphine consumption,… Continue reading Gabapentin and Spinal Surgery – a Meta-analysis

Basic Sciences & Physiology · Haemodynamics · ICP/CPP management · Neurocritical Care · Neuromonitoring · Traumatic Brain Injury

Cerebral Autoregulation – What do we know?

We all recall the elegant curves that ostensibly show the neat relationship between mean  arterial blood pressure (or CPP) and cerebral blood flow. This relationship classically has its lower and upper limits, beyond which CBF will vary passively with the systemic pressure. Stay within these limits and all is good, the mantra goes. However, as… Continue reading Cerebral Autoregulation – What do we know?

Hypothermia · Neurocritical Care · Neuroprotection · Traumatic Brain Injury

TTM – New Guidelines from NCS

Targeted temperature management (TTM) as a neuroptotective strategy is applied in a number of scenarios; post-ROSC in cardiac arrest, neonatal asphyxia, traumatic brain injury, to name some. The Neurocritical Care Society have taken it upon themselves to formulate an evidence-based guideline to  the implementation and practical management of TTM in a number of settings. Although… Continue reading TTM – New Guidelines from NCS

Cardiovascular Conditions · Haemodynamics · Systemic Effects of CNS Pathology · Traumatic Brain Injury

Beta-blockers and TBI

This is a subject that has been on our backburner for a while and it’s now due for a discussion on The use of beta-blockers in traumatic brain injury is nothing new. The indications have been largely centered on targeting and preventing paroxysmal sympathetic hyperactivity (PSH) and associated post-TBI autonomic phenomena. Please see our… Continue reading Beta-blockers and TBI