1,721,260 research outputs found
Admission hyperglycemia and outcome in ICU patients with sepsis
Full text linkStress hyperglycemia is a very common feature in the intensive care (ICU) setting and it is related to multiple causes that include inflammatory and neuro-endocrine derangements in critically ill patients, which lead to insulin resistance and high hepatic glucose output (1). The target for glucose management in this population and its relationship with the patients’ outcome is not clear, and results from literature are contrastin
Traumatic brain injury and translational research: pharmacological and nonpharmacological perspectives
No full textNon-invasive assessment of ICP in children: advances in ultrasound-based techniques
Full text linkThe assessment of intracranial pressure (ICP) in children with neurological disease remains a cornerstone in their routine management. The quest for a reliable, reproducible and radiation-free non-invasive technique for assessing ICP in children remains somewhat of a holy grail for neurosurgery. This work assesses some of the recent advances in ultrasound-based techniques, addressing both novel processes and modifications aimed at improving the accuracy of existing techniques.acceptedVersio
Ten rules for optimizing ventilatory settings and targets in post-cardiac arrest patients
No full textCardiac arrest (CA) is a major cause of morbidity and mortality frequently associated with neurological and systemic involvement. Supportive therapeutic strategies such as mechanical ventilation, hemodynamic settings, and temperature management have been implemented in the last decade in post-CA patients, aiming at protecting both the brain and the lungs and preventing systemic complications. A lung-protective ventilator strategy is currently the standard of care among critically ill patients since it demonstrated beneficial effects on mortality, ventilator-free days, and other clinical outcomes. The role of protective and personalized mechanical ventilation setting in patients without acute respiratory distress syndrome and after CA is becoming more evident. The individual effect of different parameters of lung-protective ventilation, including mechanical power as well as the optimal oxygen and carbon dioxide targets, on clinical outcomes is a matter of debate in post-CA patients. The management of hemodynamics and temperature in post-CA patients represents critical steps for obtaining clinical improvement. The aim of this review is to summarize and discuss current evidence on how to optimize mechanical ventilation in post-CA patients. We will provide ten tips and key insights to apply a lung-protective ventilator strategy in post-CA patients, considering the interplay between the lungs and other systems and organs, including the brain
Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study. Robba C, Graziano F, Guglielmi A, Rebora P, Galimberti S, Taccone FS, Citerio G; SYNAPSE-ICU Investigators.Intensive Care Med. 2023 Jan;49(1):50-61. doi: 10.1007/s00134-022-06937-1. Epub 2023 Jan 9.PMID: 36622462
No full textLetter to the Editor Regarding “First Intracranial Pressure Monitoring or First Operation: Which One Is Better?”
No full textTrajectories of early secondary insults after traumatic brain injury: a new approach to evaluate impact on outcome
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Neuro-ICU patient disposition: optimal venue for acute needs
No full textPurpose of review
This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic
brain injury (TBI) patients, postoperative neurosurgical procedures and stroke].
Recent findings
The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date
there are no widely accepted international guidelines for managing these acute brain-injured patients
(stroke, TBI, postneurosurgery) in the ICU. The criteria for ICU admission after neurological acute injury,
high-dependency unit or a specialized neurosurgical ward vary from institution to institution depending on
local structures and characteristics of the available resources. Better evidence to standardize the treatment
and the degree of monitoring is needed during neurological acute injury. It is highly recommended to
implement clinical vigilance in these patients regardless of their destination (ICU, stroke unit or ward).
Summary
Currently evidence do not allow to define standardized protocol to guide ICU admission for acute
neurological patients (TBI patients, postoperative neurosurgical procedures and strok
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