Abstract:
INTRODUCTION:Liver transplant (LT) recipients are at significant risk for the development of neurological complications, such as altered mental status and seizures, in the postoperative period. Identifying accurate predictors of these events may allow optimal selection and preparation of candidates, and minimize risk after transplantation. METHODS:One hundred and one consecutive adult LT recipients were evaluated retrospectively for neurological morbidity occurring in the first 30 days postoperatively. These events were analyzed in relation to specific predictive variables including preoperative complications of liver failure, such as hepatic encephalopathy (HE). RESULTS:Median age was 50 years, 63% were male and hepatitis C was the most common indication for LT (n = 36). Median Child-Pugh score was 9 with 45% being Class C. Over half (n = 52) had experienced clinical HE prior to LT, while one quarter (n = 26) were encephalopathic at the time of LT. Neurological complications occurred in 31 patients in the postoperative period, with encephalopathy occurring in 28 and seizures occurring in 4; drug toxicity was responsible for neurological morbidity in 12 patients (39%). Length of hospital stay was significantly prolonged (median 19 vs. 12 days, P = 0.005) and all mortality (n = 3) occurred in those with neurological complications. There was no association between etiology of liver failure and complications; logistic regression identified active preoperative HE as the strongest predictor of postoperative morbidity (OR 10.7 95% CI 3.8-29.9). CONCLUSION:Neurological events, manifesting most often as encephalopathy, occurred in almost one-third of patients after LT. Those suffering from HE at the time of LT may be more vulnerable to the metabolic stresses of surgery and the neurotoxicity of the drugs used, and were at highest risk for such complications.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Dhar R,Young GB,Marotta Pdoi
10.1007/s12028-007-9020-4subject
Has Abstractpub_date
2008-01-01 00:00:00pages
253-8issue
2eissn
1541-6933issn
1556-0961journal_volume
8pub_type
杂志文章abstract:BACKGROUND:We hypothesized that the degree of preserved functional connectivity within the DMN during the first week after cardiopulmonary arrest (CPA) would be associated with functional outcome at hospital discharge. METHODS:Initially comatose CPA survivors with indeterminate prognosis at 72 h were enrolled. Sevente...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9953-3
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:The incidence of spinal epidural abscesses (SEAs) is rising. Although increased awareness has led to decreased mortality, morbidity remains unacceptably high, with rapid deterioration of neurological status when there is a delay in initiation of treatment. Therefore, we need to build a better understanding...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:2:3:245
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Pooled European trial results of early decompressive craniectomy (DC) for severe hemispheric stroke did not require radiographic mass effect as an inclusion criterion. Early surgery for supratentorial cerebral hemorrhage does not improve functional status or survival compared to initial conservative medical ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0270-x
更新日期:2016-08-01 00:00:00
abstract:INTRODUCTION:Delayed posthypoxic demyelination may rarely complicate an episode of severe hypoxia, with or without exposure to carbon monoxide. Following recovery from initial coma, progressive neurologic deterioration ensues with outcomes ranging from death to full recovery. Delayed posthypoxic demyelination is hypoth...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0044-6
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Infection in the intensive care unit (ICU) empirically requires broad-spectrum antibiotics. Imipenem/cilastatin, often reserved for more serious hospital-acquired infections, is thought to be associated with a higher risk of seizures than other penicillins and carbapenems. We sought to evaluate the safety of...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9170-z
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:In comatose post-cardiac arrest patients, a serum neuron-specific enolase (NSE) level of >33 μg/L within 72 h was identified as a reliable marker for poor outcome in a large Dutch study (PROPAC), and this level was subsequently adopted in an American Academy of Neurology practice parameter. Later studies rep...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9867-5
更新日期:2013-10-01 00:00:00
abstract::In the original article, Figure 5 has incorrect EEG images and the corrected version is shown below. ...
journal_title:Neurocritical care
pub_type: 杂志文章,已发布勘误
doi:10.1007/s12028-020-00981-9
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Intravenous (IV) lacosamide use for status epilepticus has increased in recent years and is recommended for refractory status epilepticus by current guidelines. Per the lacosamide package labeling, the preferred route of administration is diluted and infused over 30-60 min; however, administration ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0560-6
更新日期:2018-12-01 00:00:00
abstract::Computed tomography (CT) scan of the brain transitioned clinical neurology from the educated-guess world to the real computer-age world. One of the first CT scans-published by the British neuroradiologist James Ambrose-showed an intracranial hemorrhage and also suggested the use of iodine to demonstrate abnormal blood...
journal_title:Neurocritical care
pub_type: 历史文章,杂志文章
doi:10.1007/s12028-017-0495-3
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Several methods have been proposed to measure cerebrovascular autoregulation (CA) in traumatic brain injury (TBI), but the lack of a gold standard and the absence of prospective clinical data on risks, impact on care and outcomes of implementation of CA-guided management lead to uncertainty. AIM:To formulat...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01185-x
更新日期:2021-01-25 00:00:00
abstract::Maintenance of adequate oxygenation is a mainstay of intensive care, however, recommendations on the safety, accuracy, and the potential clinical utility of invasive and non-invasive tools to monitor brain and systemic oxygenation in neurocritical care are lacking. A literature search was conducted for English languag...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0024-6
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND/PURPOSE:Blood type has become an increasingly recognized risk factor for coagulopathy. We explored the association between blood type and hematoma expansion (HE) after intracerebral hemorrhage (ICH). METHODS:Spontaneous ICH patients prospectively enrolled in an ongoing ICH cohort study at Columbia Universit...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0655-0
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:To determine the clinical characteristics and outcomes of patients with neurogenic stress cardiomyopathy (NSC) among patients admitted to our neuroscience intensive care unit (NICU). METHODS:Following institutional review board approval, consecutive adult patients admitted to the NICU between 2009 and 2013 w...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0412-9
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:The objective of our trial was to obtain more comprehensive data on the risks and benefits of kinetic therapy in intensive care patients with intracerebral pathology. METHODS:Standardized data of prone positioning in our NeuroIntensive Care Unit were collected from 2007 onward. A post hoc analysis of all avail...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-014-0004-x
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Global cerebral edema (GCE) is a manifestation of early brain injury (EBI) after subarachnoid hemorrhage (SAH) and is an independent risk factor for poor outcome. The lack of a quantitative method to measure GCE limits the study of its pathophysiology. The goal of this study is to develop a quantitative surr...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-015-0229-3
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Cerebral edema and raised intracranial pressure are common problems in neurological intensive care. Osmotherapy, typically using mannitol or hypertonic saline (HTS), has become one of the first-line interventions. However, the literature on the use of these agents is heterogeneous and lacking in class I stud...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9477-4
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Although hydrocephalus is often treated with permanent cerebrospinal fluid (CSF) shunting during hospitalization for acute aneurysmal subarachnoid hemorrhage (SAH), little is known about the development of delayed hydrocephalus. METHODS:Using administrative data on all visits to nonfederal emergency departm...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-0072-y
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The most widely used and most studied coma score to date is the Glasgow Coma Scale (GCS), which is used worldwide to assess level of consciousness and predict outcome after traumatic brain injury (TBI). Our aim was to determine whether the Full Outline of UnResponsiveness (FOUR) score is an accurate predicto...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9617-5
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:In recent years, the noble gas argon (Ar) has been extensively studied for its organ protection properties. While mounting in vitro and in vivo evidence indicates that argon provides neuroprotection in ischemic brain injury, its neuroprotective potential in traumatic brain injury (TBI) has not been...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01104-0
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:During late pregnancy and the puerperium cerebral venous and sinus thrombosis (CVST) is a rare but important cause of stroke. Despite adequate anticoagulation some patients deteriorate, which may warrant the use of more aggressive treatment modalities. CASE REPORT:A 29-year-old pregnant woman (29th week of ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9389-3
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N(2)O) an...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9363-0
更新日期:2010-08-01 00:00:00
abstract:INTRODUCTION:An oculomotor palsy in the setting of aneurysmal subarachnoid hemorrhage is often due to compression by a posterior communicating artery aneurysm. Anterior communicating artery (ACOM) aneurysms may produce ophthalmologic symptoms of the anterior visual pathways, but rarely ever lead to a 3rd nerve palsy. T...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0054-4
更新日期:2007-01-01 00:00:00
abstract::Multi-modal monitoring has become an integral part of neurointensive care. However, our approach is at this time neither standardized nor backed by data from randomized controlled trials. The goal of the second Neurocritical Care Research Conference was to discuss research priorities in multi-modal monitoring, what re...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-015-0134-9
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults. METHODS:The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-...
journal_title:Neurocritical care
pub_type: 杂志文章,随机对照试验
doi:10.1007/s12028-016-0313-3
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in th...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9942-y
更新日期:2014-04-01 00:00:00
abstract::Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a uniq...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-016-0338-7
更新日期:2017-08-01 00:00:00
abstract::The objective of this study was to determine the prevalence of intracranial hypertension (IHT) and the associated mortality rate in patients who suffered from primary intracerebral hemorrhage (ICH). A secondary objective was to assess predisposing factors to IHT development. We conducted a systematic literature search...
journal_title:Neurocritical care
pub_type: 杂志文章,meta分析
doi:10.1007/s12028-018-0658-x
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O2) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at lim...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-017-0380-0
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) has been associated with pronounced acute sympathetic activation. The purpose of this investigation is to identify demographic, clinical, radiological, and anatomical features of SAH that relate to sympathetic activation. METHODS:Observational study of consecutive Grades 3-5 SA...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9673-5
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:Recent and on going clinical research trials may indicate that the incidence of vasospasm is less in patients treated with lumbar drains following SAH than with patients treated with external ventricular drainage (EVD) alone. These studies have sparked interest in the more aggressive use of LDs in patients...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0047-3
更新日期:2007-01-01 00:00:00