Acute Cerebrovascular Conditions · Air Embolism · Aneurysm Surgery · Cervical Spine Surgery · General Topics · Haemodynamics · ICP/CPP management · Intracranial Surgery General · Ischaemic Stroke · Neuroanaesthesia · Neuromonitoring · Neurovascular Surgery · Perioperative Management · Sedation · Seizure Control · Subarachnoid Haemorrhage · Thoracolumbar Spine Surgery · US Guidelines · Ventilation and Oxygenation

SNACC – How to Handle Neuroanaesthetic Emergencies

From our quality-focused colleagues at the Society for Neuroscience in Anesthesiology and Critical Care (SNACC) comes this set of guidelines for management of the most common emergencies encountered in neuroanaesthetic practice. Conceived with the purpose of addressing complex emergent issues in a concise, goal-directed and simplified manner, these cognitive aids are clear-cut and based on… Continue reading SNACC – How to Handle Neuroanaesthetic Emergencies

Fluid Management · Neuroanaesthesia · Osmotherapy · Paediatrics · Perioperative Management

Balanced Crystalloids Better Than Isotonic Saline for Craniotomy in Kids?

In this interesting trial by Lima and colleagues, with findings published recently in the Journal of Neurosurgical Anesthesiology, the authors compare normal saline (NS) with a balanced crystalloid as a maintenance fluid for elective tumour resection in paediatric patients. Their main endpoint was change in serum chloride from baseline to end of surgery. Perhaps unsurprisingly… Continue reading Balanced Crystalloids Better Than Isotonic Saline for Craniotomy in Kids?

Basic Sciences & Physiology · Fluid Management · General Topics · Neurocritical Care · Neuroprotection · Osmotherapy

Hyponatraemia and the Brain – Review

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.

Acute Cerebrovascular Conditions · Anaesthetic Agents · Ischaemic Stroke · Neuroanaesthesia · Sedation

Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?

A recently published review [1] 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?

Acute Cerebrovascular Conditions · European Guidelines · Fluid Management · 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