I came across this useful little review in Kidney International Reports covering a subject I always find difficult to grasp: sodium disturbances and their influence on the brain. The article delves into the matter in a concise and understandable way, making it just about manageable even for an anaesthetist.
Meyfroidt and colleagues recently published a commentary in Intensive Care Medicine addressing ten tenets in neurocritical care that merit debate. The article deals with the following ten statements: 1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain… Continue reading Meyfroidt et al in ICM: Ten false beliefs in neurocritical care
Tranexamic acid (TXA) has been held as something of a wonder drug. It’s cheap, largely demonstrated to be safe and has been given a role in a number of settings. The 2013 CRASH-2 trial showed improved survival in trauma with bleeding, and thus became one of the most widely cited publications in traumatology and emergency medicine. Several… Continue reading TICH-2: No Benefit From TXA in ICH. What Now?
Excellent and widely read overview of sedation regimes in acute brain injury. Find the article by Oddo et al in Critical Care here.
From our fellow anaesthetist Lars Prag Antonsen comes this eye-opening essay on cognitive processes and how we apply them in high-pressure settings. Very relevant for anaesthetic practice as well as being an enjoyable read. Find the full-text article in the Journal of the Norwegian Medical Association here.
A recently published review  by our Danish colleagues sums up the more recent trials on the subject of anaesthetic technique for endovascular treatments of ischaemic stroke. Previous publications, many of which are based largely on observational or retrospective data, have suggested harm from general anaesthesia (GA) for these procedures, when compared with conscious sedation… Continue reading Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?
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