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
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
It’s been a lazy summer on our part, so it’s time to get back to business. And we’ll start off with this article by Moustafa et al, which was recently published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. The authors deal with the issue of predicting risk of intracranial haemorrhage in TBI patients… Continue reading Predictive Factors of Traumatic Intracranial Haemorrhage in Patients on Anti-platelet Agents
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.
Meyfroidt and colleagues recently published a commentary in Intensive Care Medicine addressing ten tenets in neurocritical care that merit debate. The article deals with the following ten statements: 1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain… Continue reading Meyfroidt et al in ICM: Ten false beliefs in neurocritical care
Tranexamic acid (TXA) has been held as something of a wonder drug. It’s cheap, largely demonstrated to be safe and has been given a role in a number of settings. The 2013 CRASH-2 trial showed improved survival in trauma with bleeding, and thus became one of the most widely cited publications in traumatology and emergency medicine. Several… Continue reading TICH-2: No Benefit From TXA in ICH. What Now?
Excellent and widely read overview of sedation regimes in acute brain injury. Find the article by Oddo et al in Critical Care here.
From our fellow anaesthetist Lars Prag Antonsen comes this eye-opening essay on cognitive processes and how we apply them in high-pressure settings. Very relevant for anaesthetic practice as well as being an enjoyable read. Find the full-text article in the Journal of the Norwegian Medical Association here.
A recently published review [1] by our Danish colleagues sums up the more recent trials on the subject of anaesthetic technique for endovascular treatments of ischaemic stroke. Previous publications, many of which are based largely on observational or retrospective data, have suggested harm from general anaesthesia (GA) for these procedures, when compared with conscious sedation… Continue reading Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?
The 2015 joint American Heart Association/American Stroke Association guidelines for ICH-management can be found here.
neuroscand.com 