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 · European Guidelines · Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · Traumatic Brain Injury

Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Just published: the European Society of Intensive Care Medicine´s consensus document on fluid administration in the NICU. It covers all manner of neurocritical conditions and sums up the available evidence for various fluid therapy approaches. As expected there are few recommendations that aren´t already well established and by now fairly uncontroversial (multimodal monitoring, avoiding colloids,… Continue reading Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Basic Sciences & Physiology · Haemodynamics · ICP/CPP management · Neurocritical Care · Neuromonitoring · Traumatic Brain Injury

Cerebral Autoregulation – What do we know?

We all recall the elegant curves that ostensibly show the neat relationship between mean  arterial blood pressure (or CPP) and cerebral blood flow. This relationship classically has its lower and upper limits, beyond which CBF will vary passively with the systemic pressure. Stay within these limits and all is good, the mantra goes. However, as… Continue reading Cerebral Autoregulation – What do we know?

Decompressive Surgery · discussions · ICP/CPP management · TBI General · Traumatic Brain Injury

RESCUEicp Trial Results Finally Out: Craniectomy in TBI Lowers Mortality, But Survivors Suffer Worse Neurological Outcomes

After completing recruitment of some 408 TBI patients in 2014, the RESCUEicp group finally published the results from this eagerly awaited trial. The article by Hutchinson et al, titled Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension, was published on September 7th in the New England Journal of Medicine. So let´s go straight to the core: The study… Continue reading RESCUEicp Trial Results Finally Out: Craniectomy in TBI Lowers Mortality, But Survivors Suffer Worse Neurological Outcomes

ICP/CPP management · Neuroprotection · TBI General · Thermoregulation · Traumatic Brain Injury

Eurotherm 3235 Trial

The long-awaited Eurotherm trial was published in NEJM in autumn 2015. The premise of the study was to examine the impact of induced hypothermia on outcomes after traumatic brain injury. In a multi center randomized controlled trial patients were allocated to either therapeutic hypothermia (32-35 degrees) or the control group (standard care, normothermia). The study… Continue reading Eurotherm 3235 Trial

Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · TBI General

Critical Care: Fluid Therapy in Neurological Patients

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