Tag: TBI
Hematologic Challenges in the Critically Ill
This volume provides a comprehensive overview of hematologic issues that clinicians regularly encounter in the critical care environment. The text features hematologic scenarios that affect the adult ICU patient, outlines... read more
Strategies for Mechanical Ventilation in Patients with Brain Injury
Although direct data to guide mechanical ventilation in brain-injured patients is accumulating, the current evidence base remains limited. Ventilatory considerations in this population should be extrapolated from high-quality... read more
Acute Effects of Ketamine on ICP in Children With Severe TBI
In this retrospective, exploratory study, intracranial pressure (ICP) did not increase following ketamine administration. In the setting of a guidelines-based protocol, ketamine was associated with a reduction in ICP during... read more
Intracranial Pressure: Current Perspectives on Physiology and Monitoring
Intracranial pressure (ICP) monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. It serves... read more
Multiple Organ Dysfunction in Older Major Trauma Critical Care Patients
Frailty rather than chronological age appears to drive multiple organ dysfunction syndrome (MODS) development, recovery, and outcome in older cohorts. Early identification of frailty after trauma may help to predict MODS... read more
Casemix, management, and mortality of patients receiving emergency neurosurgery for TBI
Patients receiving emergency neurosurgery for traumatic brain injury (TBI) differed considerably in their admission characteristics and management across human development settings. Level of human development was associated... read more
Why Are We Still Talking about ICP and Ketamine?
A trauma patient required emergent intubation during a recent shift. The altered patient was suspected of having an intracranial bleed. My resident was concerned about rapid onset of hypoxia and other internal injuries causing... read more
Therapeutic Hyperthermia Associated with Improved Survival in Afebrile Critically Ill Patients with Sepsis
Participants randomized to external forced-air warming did not have a difference in HLA-DR expression or IFN-γ production. In this pilot study, however, 28-day mortality was lower in the intervention group. Future research... read more
Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS
Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine. Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive... read more
Cerebral Hypoperfusion Detection with Dynamic Hyperoxia Test
In a heterogeneous population of acute brain-injured patients, cerebral multimodal monitoring with intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO2) detected regional cerebral hypoperfusion with a higher... read more
Cluster ICU Treatment Strategies for TBI by Hospital Treatment Preferences?
Although correlations between treatment policies within domains were found, the failure to cluster hospitals indicates that a specific treatment choice within a domain is not a proxy for other treatment choices within or... read more
Feasibility of Conservative Fluid Administration and Deresuscitation vs. Usual Care
A strategy of conservative fluid administration and active deresuscitation is feasible, reduces fluid balance compared with usual care, and may cause benefit or harm. In view of wide variations in contemporary clinical... read more
Intravenous Push Levetiracetam Safety in a Neuro-Spine ICU
Administration of levetiracetam doses up to 2000 mg via IVP is a safe method of administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use. Of the 2,055 hospital-wide... read more
Hospitals With and Without Neurosurgery: Evaluating TBI Patients Outcomes
In our study, centralization of TBI patients significantly impacted short- and long-term outcomes. For TBI patients admitted to no-NSH centers, our results suggest that the least critically ill can effectively be managed... read more
Effect of Statins on Cognitive Outcome After TBI
Traumatic brain injury (TBI), also known as the "Silent Epidemic," is a growing devastating global health problem estimated to affect millions of individuals yearly worldwide with little public recognition, leading to many... read more
Understanding Brain Injury in Pediatric ECMO
Brain injury is frequent in extracorporeal membrane oxygenation patients, although the majority of survivors have favorable neurocognitive outcomes. More research is needed in order to understand the etiology of such... read more
Imputation Strategies for Missing Baseline Neurological Assessment Covariates After TBI
Statistical models for outcome prediction are central to traumatic brain injury (TBI) research and critical to baseline risk adjustment. Glasgow coma score (GCS) and pupil reactivity are crucial covariates in all such models... read more
Dealing with missing delirium assessments in prospective clinical studies of the critically ill
For longitudinal data where a summary exposure is of interest, we recommend practitioners adopting the passive imputation strategy. Simulations show that all methods performed comparably when the proportion of missingness... read more
ICP Monitoring in Patients with Acute Brain Injury
The use of intracranial pressure (ICP) monitoring and ICP management varies greatly across centres and countries. The use of ICP monitoring might be associated with a more intensive therapeutic approach and with lower 6-month... read more
Point-of-Care Transcranial Doppler by Intensivists
In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimensional transcranial... read more
Diagnostic accuracy of prehospital serum S100B and GFAP in patients with mild TBI
Early prehospital and in-hospital S100B levels 0.10 μg/L was 100% (95%CI: 89.1;100.0) in prehospital samples and 100% (95% CI 89.1;100.0) in in-hospital samples. The specificity was 15.4% (95%CI: 12.4;18.7) in prehospital... read more
Effect of Continuous Infusion of Hypertonic Saline vs. Standard Care in Patients With TBI
Among patients with moderate to severe traumatic brain injury (TBI), treatment with continuous infusion of 20% hypertonic saline compared with standard care did not result in a significantly better neurological status at... read more
