Recently released Podcast by HEFT -EMCast (Heart of England Foundation Trust’s Emergency Department) on status epilepticus. Latest evidence digested and made clinically useful. Special emphasis on early and aggressive treatment for those patients who don´t seem likely to recover after initial first-line management. Largely based on the NICE guidelines from 2012.
A colleague wants to hear if anyone has experience with dexmedetomidine in neurocritcal care: adults and children ? We want to open a discussion on the subject and would like your input. Please add you comments below.
The excellent reviewers at The Bottom Line are taking a thorough look at the STITCH (Trauma) trial of 2015. The STITCH (Trauma) trial (Early Surgery versus Initial Conservative Treatment in Patients with Traumatic Intracerebral Hemorrhage) recruited 170 patients into a multicenter RCT to determine whether early surgery (within 12 hours) for traumatic intracerebral haemorrhage would confer a mortality benefit… Continue reading The Bottom Line – The STITCH Trial
Abstract: Hypotension in anaesthetized patients during aneurysm clipping: not as bad as expected? Acta Anaesthesiol Scand. Hoff et al. Acta Anaesthesiologica Scandinavica, 2008. Kindly brought to our attention courtesy of our colleague Dr. Romundstad at Oslo University Hospital.
Pressure-derived versus pressure wave amplitude-derived indices of cerebrovascular pressure reactivity in relation to early clinical state and 12-month outcome following aneurysmal subarachnoid haemorrhage. Abstract of original article by Eide et al. Published in the Journal of Neurosurgery 2012.
Routine intracranial pressure monitoring in acute coma (Cochrane 2015) A recent review of the available literature, pointing to the lack of sufficient evidence concerning the use of ICP monitoring in acute coma. Only one RCT has been conducted (see here) but this trial was questioned on the grounds of a disproportionally high mortality in both… Continue reading Cochrane review of routine ICP measurement in acute coma (2015)
Neurogenic Pulmonary Oedema by Dr John Griffiths of Anaesthesia UK. A very nice synopsis of this very relevant topic.
“The author recommends a controlled anesthesia induction by trained pediatric anesthesiologist with suitable equipment for the children considered at risk of pulmonary aspiration.” Rapid sequence induction has no use in pediatric anesthesia. Engelhard, UK. Paediatric Anaesthesia, 2015 Jan. Read the abstract from the review article here.
The latest version of a Cochrane review of barbiturate therapy for ICP-management. “There is no evidence that barbiturate therapy in patients with acute severe head injury improves outcome. Barbiturate therapy results in a fall in blood pressure in one in four patients. This hypotensive effect will offset any ICP lowering effect on cerebral perfusion pressure”… Continue reading Cochrane Review – Barbiturates for acute traumatic brain injury
Very useful and concise overview of raised ICP and its associated ECG findings, by the guys at Life In The Fast Lane.
neuroscand.com 