Category: Neuroanaesthesia

Acute Cerebrovascular Conditions · Haemodynamics · Neuromonitoring · Subarachnoid Haemorrhage

Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

andersfeylingLeave a comment

Published in 2011 by Schmidt et al (free full-text in Stroke), this article looks at CPP thresholds for cerebral hypoxia in SAH patients. They went through multimodal monitoring data for 30 patients with poor-grade SAH. Using microdialysis and brain tissue oxygenation as their main determinants of hypoxia, they found that patients with a CPP <70… Continue reading Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

Fluid Management · Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · TBI General

Critical Care: Fluid Therapy in Neurological Patients

andersfeylingLeave a comment

Right off the press: an open access review article from Critical Care on fluid therapy in the neurological patient. It provides a nice synopsis of the different fluid therapy paradigms that are advocated through various guidelines. The review challenges some of the tenets of basic treatment, such as empirical fluid maintenance and the definition of… Continue reading Critical Care: Fluid Therapy in Neurological Patients

Coagulopathy and Bleeding · discussions · Intracranial Surgery General

Anticoagulants and Neurosurgery – What´s Your Policy?

andersfeylingLeave a comment

On behalf of our colleague Dr. Ann-Christine Lindroos of Töölö Hospital in Helsinki, Finland we´d like to solicit your opinion on the discontinuation of anticoagulant medication in neurosurgical practice. We´d love to hear from as many of our colleagues as possible. Feel free to comment below and share your institution´s policy with NeuroScand users. In Dr. Lindroos´own… Continue reading Anticoagulants and Neurosurgery – What´s Your Policy?

Airway Management · Systemic Effects of CNS Pathology · TBI General · Ventilation and Oxygenation

Brain Impact Apnea

andersfeyling1 Comment

Immediate apnea after acute head trauma is a concept that has received renewed focus lately. BIA/IBA (Brain Impact Apnea or as some call it, Impact Brain Apnea) was described in animal models as far back as 1874 by Koch and Filehne (1). A number of subsequent studies (2-5) have established a clear link between severity of impact and duration of… Continue reading Brain Impact Apnea

ICP/CPP management · Intracranial Surgery General · Osmotherapy

Cochrane Review – Mannitol vs. HS in Patients Undergoing Craniotomy

andersfeylingLeave a comment

Cochrane review from 2014: Mannitol versus hypertonic saline for brain relaxation in patients undergoing craniotomy. By Prabhakar et al.   “From the limited data available on the use of mannitol and hypertonic saline for brain relaxation during craniotomy, it is suggested that hypertonic saline significantly reduces the risk of tense brain during craniotomy”

Airway Management · Podcasts

Awake Intubation Lecture from SMACC

AC. FeylingLeave a comment

“Dry them out”; use glycopyrrolate (no central effects). How to use local anesthetics and more… emcrit.org  Listen to the podcast here. EMcrit recommend: Airway Regional Anesthesia for Awake Fiberoptic Intubation, Simmons et al, Regional Anesthesia and Pain Medicine 2002. Read the review article here. Fibreoptic vs videolaryngoscopic (C-MAC(®) D-BLADE) nasal awake intubation under local anesthesia. Kramer et al. Anaesthesia. 2015… Continue reading Awake Intubation Lecture from SMACC