Neurocritical Care · Neuroprotection · Neurotrauma · Traumatic Brain Injury

Glycaemic Control Targets After Traumatic Brain Injury: A Systematic Review and Meta-analysis

Hermanides and colleagues recently reviewed all available evidence on blood glucose targets in the TBI patient. Read their finding in this article in Critical Care. When comparing strict glycaemic regimens with more liberal strategies they found no significant differences in patient-important outcomes, contrary to earlier findings. They did reveal an increased risk of hypoglycaemia, however.… Continue reading Glycaemic Control Targets After Traumatic Brain Injury: A Systematic Review and Meta-analysis

Acute Cerebrovascular Conditions · Neurocritical Care · Neurotrauma · Scandinavian Guidelines

Best Practice Guidelines for Blunt Cerebrovascular Injuries – SJTREM

Blunt cerebrovascular injury is a relatively common finding in the traumatised patient and poses a number of clinical challenges. A Scandinavian group recently issued best practice guidelines for management of these injuries. You can find the article (free full-text) by Brommeland et al here.

Acute Cerebrovascular Conditions · Ischaemic Stroke · Neurocritical Care · US Guidelines

AHA/ASA Guidelines for Early Management of Patients with Acute Ischaemic Stroke

These guidelines were updated in 2018 and can be found here. Of special interest is the reversal of the recommendation to avoid general anaesthesia for thrombectomy in stroke, in view of newer data. The choice of conscious sedation versus GA should be individualised and are both approaches are acceptable, according to the revised guidelines. More on… Continue reading AHA/ASA Guidelines for Early Management of Patients with Acute Ischaemic Stroke

ICP/CPP management · Neurocritical Care · Neuroprotection · Neurotrauma · Thermoregulation · Traumatic Brain Injury

POLAR RCT – Don’t Worry, Thermoregulation Isn’t Dead Quite Yet

POLAR RCT is probably the most anticipated neurotrauma trial of the year and its findings were finally presented at this year’s ESICM congress in Paris. Before I comment on what POLAR RCT is all about, it’s worth taking some time to consider what this trial is NOT about. It does not deal specifically with TBI… Continue reading POLAR RCT – Don’t Worry, Thermoregulation Isn’t Dead Quite Yet

Acute Cerebrovascular Conditions · Basic Sciences & Physiology · Neurocritical Care · Neuromonitoring · Neuroprotection

Lactate Improves Cerebral Perfusion After Acute Brain Injury – Recent Clinical Trial in Crit Care Med

Lactate is well-known as an important energy substrate for brain tissue and plays a key role in neuroenergetics. Experimental data have shown that exogenous lactate administration may improve metabolism in injured brain cells, and possibly has neuroprotective properties. Till now there has been a paucity of human clinical studies on this subject. Carteron et al… Continue reading Lactate Improves Cerebral Perfusion After Acute Brain Injury – Recent Clinical Trial in Crit Care Med