In December 2019 the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society and the Neuro Anaesthesia and Critical Care Society published their joint guidelines on how to safely transfer patients with acute brain injury to the appropriate level of care. Focusing on TBI and stroke-related brain injury, this consensus document outlines both… Continue reading Joint AAGBI & NACCS Guidelines on Safe Transfer of the Brain Injured Patient
Our Danish colleagues have recently issued updated guidelines on spinal stabilisation of adult trauma patients (open-access in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine). As expected, the evidence base is fairly limited as robust randomised studies on this topic are rare and often hard to conduct. The group does provide a strong recommendation… Continue reading New Danish Guidelines on Spinal Stabilisation in Trauma
The optimal hyperosmotic agent for treatment of intracranial hypertension following TBI has been an inexhaustible subject of debate. Scant evidence underlies these discussions despite widespread and long-standing use of both agents. In this article Anstey et al. retrospectively analysed data from 14 different centres to compare outcomes in mannitol-only and hypertonic saline-only cohorts. They excluded… Continue reading Mannitol vs. Hypertonic Saline in TBI – A Retrospective Study
SNACC’s article of the month for July is an excellent narrative review on the pharmacodynamics of vasopressors in health and in the setting of brain injury. The review is preceded by an introductory commentary by neuroscand.com contributor Dr. Riikka Takala.
The ever-increasing use of direct (or novel) oral anticoagulants (DOACs) has had a profound effect on primary and secondary prevention of thromboembolic events, especially in the elderly. Whilst many patients benefit from switching over to these newer drugs from older anticoagulants like warfarin, thus foregoing such nuisances as INR-guided dosing, they have also inevitably led… Continue reading Impact of DOACs in TBI in the over 60s
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
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?