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
Moerman et al, Anesthesiology Aug 2015. Link to PubMed here. In this study, paradoxical changes in ScO2 after pharmacological-induced pressure changes occurred exclusively in patients with intact cerebral autoregulation, corroborating the hypothesis that these paradoxical responses might be attributable to a functional cerebral autoregulation.
A quick review published in BMJ´s Best Evidence Topic Reports series, April 2016 by Kapil Mohan Rajwani and Azlisham Mohd Nor. They address the issue of lowering elevated blood pressures in patients with an acute ICH. Is it safe and is there evidence to support active BP-management? And if yes, what´s our target? Targeted blood pressure management in… Continue reading Best BETs – Safe to Lower BP in ICH?
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?
An Evidence-Based Consensus Statement from the Neurocritical Care Society. Read more here. Best regards, Riikka Takala.
A Statement for Healthcare Professionals from the Neurocritical Care Society. Read more here. Best regards, Riikka Takala.
This guideline, issued jointly by the Neurocritical Care Society and Society of Critical Care Medicine and published in Neurocrit Care December 2015, provides timely and evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. Read the statement here. Best regards, Riikka Takala.
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
Now more than three years old, but still an absolute landmark study and mandatory reading for anyone who cares for neurotrauma patients. Smallish trial but very well carried out and yielding some remarkable findings. A commonly cited article by Randy Chesnut and his group showing equipoise between an ICP-driven protocol and management determined by CT… Continue reading BEST TRIP – ICP vs. CT/clinical exam for TBI
Survival improvement in Critical neurotrauma and the Triss model. Link to the abstract here. Sudden survival improvement in critical neurotrauma: An exploratory analysis using a stratified statistical process control technique. Søvik et al, Norway. Injury, 2014 Nov.
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