Tag: TBI
Blood test may obviate need for head CTs in brain trauma evaluation
A biomarker test based on the presence of two proteins in the blood appears to be suitable for ruling out significant intracranial injuries in patients with a history of mild traumatic brain injury (TBI) without the need... read more
Presenting Characteristics Associated With Outcome in Children With Severe TBI
Severe traumatic brain injury is a clinically heterogeneous disease that can be accompanied by a range of neurologic impairment and a variety of injury patterns at presentation. This secondary analysis of prospectively collected... read more
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more
Cognitive Function 3 and 12 Months After ICU Discharge
In this prospective cohort study of Danish ICU patients, we found significantly reduced cognitive function for intensive care patients 3 and 12 months after discharge. We included 161 patients, 79 patients had a 3-month and... read more
Intracranial Pressure Thresholds in Severe Traumatic Brain Injury: Pro
Teleologically, the mammalian brain has evolved to be the central component of life. It coordinates afferent and efferent neural pathways, integrates neurohormonal responses and, in humans, produces higher cortical effects... read more
Intubation in Special Patient Populations: Intracranial Hemorrhage
Lidocaine has weak evidence to support its ICP blunting effects. Fentanyl may be a better choice. Ketamine is a reasonable alternative to etomidate during induction. No differnce in mortality exists between usage of succinylcholine... read more
The Fluid Debate: Balanced or Unbalanced
Consider using balanced fluids in your ED unless you are treating a patient at risk for cerebral edema, or a patient with a chloride responsive metabolic alkalosis, e.g. from gastric losses. Although the superiority of balanced... read more
The Role of Speech and Language Therapy in Critical Care
The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech... read more
Ketamine Alters Hippocampal Cell Proliferation and Improves Learning in Mice after TBI
Ketamine alters hippocampal cell proliferation after traumatic brain injury (TBI). Surprisingly, these changes were associated with improvement in a neurogenesis-related behavioral recall task, suggesting a possible benefit... read more
Ten False Beliefs in Neurocritical Care
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 injury (TBI). 4. The threshold to treat... read more
Association Between Continuous Hyperosmolar Therapy and Survival in Patients with TBI
Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared... read more
Cerebral Autoregulation in the Prediction of Delayed Cerebral Ischemia and Clinical Outcome in Poor-Grade Aneurysmal Subarachnoid Hemorrhage Patients
High initial pressure reactivity index, presumably reflecting early brain injury, but not oxygen reactivity index, was associated with delayed cerebral ischemia and worse clinical outcome in poor-grade subarachnoid hemorrhage... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
TBI Outcomes in an LMIC Tertiary Care Centre and Performance of Trauma Scores
This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery.... read more
The Prognostic Value of MRI in Moderate and Severe TBI
Traumatic brain injury (TBI) is a major cause of death and disability, yet many predictors of outcome are not precise enough to guide initial clinical decision-making. Although increasingly used in the early phase following... read more
Long-Term Cognitive Impairment after Critical Illness
Patients in medical and surgical ICUs are at high risk for long-term cognitive impairment. A longer duration of delirium in the hospital was associated with worse global cognition and executive function scores at 3 and 12... read more
Variation in Monitoring and Treatment Policies for Intracranial Hypertension in TBI
Substantial variation was found regarding monitoring and treatment policies in patients with Traumatic Brain Injury (TBI) and intracranial hypertension. The results of this survey indicate a lack of consensus between European... read more
