Neurocritical Care · Neuroprotection · Thermoregulation

TTM 2 – No Longer Cool to Cool?

The much anticipated results of the Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest (TTM 2) trial were finally published in the New England Journal of Medicine on June 17th, to the fanfare that tends to surround trials of this magnitude and importance.  Let’s dive right into the nuts and bolts of it: TTM 2 follows… Continue reading TTM 2 – No Longer Cool to Cool?

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

January Roundup: Selected Articles on ICP, Haemodynamic Targets in Acute Brain Injury

In this post, my first one for 2021, I was lucky enough to be able to choose between a number of great recent publications. Unable to decide, I ended up including them all in one go. As they all centre around a common theme of ICP and haemodynamics, lumping them together didn’t seem entirely illogical.… Continue reading January Roundup: Selected Articles on ICP, Haemodynamic Targets in Acute Brain Injury

Neurocritical Care · Neuromonitoring · Neuroprotection · Neurotrauma · Traumatic Brain Injury

Lung Injury Is a Predictor of Cerebral Hypoxia and Mortality in Traumatic Brain Injury – Retrospective Study

This recently published open-access article by Robba et al delves into the retrospective monitoring data on 70 TBI patients. The patients in the cohort were all monitored comprehensively, providing the investigators with continuous data on PbtO2, ICP and CPP, as well as on relevant respiratory indices. They found a statistically significant link between lung function… Continue reading Lung Injury Is a Predictor of Cerebral Hypoxia and Mortality in Traumatic Brain Injury – Retrospective Study

Cervical Spine Injury · Neuroprotection · Neurotrauma · Scandinavian Guidelines · Thoracolumbar Spine Injury

New Danish Guidelines on Spinal Stabilisation in Trauma

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

Acute Cerebrovascular Conditions · Ischaemic Stroke · Neuroprotection · Thermoregulation

Addition of hypothermia to decompressive hemicraniectomy is not useful in MCA stroke – JAMA

This study, recently published in JAMA, revealed no beneficial effect from hypothermia as an adjunct to decompressive hemicraniectomy in the setting of middle cerebral artery stroke. In fact, the authors’ findings even suggest harm. Find the article here.

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

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

Basic Sciences & Physiology · Fluid Management · General Topics · Neurocritical Care · Neuroprotection · Osmotherapy

Hyponatraemia and the Brain – Review

I came across this useful little review in Kidney International Reports covering a subject I always find difficult to grasp: sodium disturbances and their influence on the brain. The article delves into the matter in a concise and understandable way, making it just about  manageable even for an anaesthetist.