Conivaptan bolus dosing for the correction of hyponatremia in the neurointensive care unit.

Abstract:

INTRODUCTION:Hyponatremia frequently complicates acute brain injury and may precipitate neurological worsening by promoting cerebral edema. An increase in brain water may be better managed through water excretion than with fluid restriction or hypertonic fluids. Vasopressin-receptor antagonists such as conivaptan, which promote free water excretion, may be ideal agents to treat this common and potentially serious disorder. METHODS:The efficacy of intermittent bolus doses of conivaptan to correct hyponatremia was examined in a consecutive series of patients treated in our neurointensive care unit. Patients were excluded if baseline sodium was over 135 mEq/l or if another conivaptan dose was given within 12 h. We assessed the proportion responding with a 4 or 6 mEq/l rise in sodium by 12 h, the change in sodium from baseline, and, in those not receiving another dose for at least 72 h, the long-term ability of a single dose to maintain sodium at least 4 mEq/l above baseline. We also recorded the effects of conivaptan on urine output and specific gravity, and noted any adverse events. RESULTS:A total of 25 doses given to 19 patients were included (out of 44 total doses administered in the study period). Sodium rose by 5.8 +/- 3.2 mEq/l within 12 h, with 71% rising by at least 4 mEq/l and 52% manifesting at least a 6 mEq/l increase. In those receiving only a single dose, 69% maintained at least a 4 mEq/l rise up to 72 h. Conivaptan also consistently led to increased urine output and a significant drop in urine specific gravity (i.e., aquaresis). No cases of phlebitis were observed despite administration of conivaptan through peripheral IVs. CONCLUSION:Intermittent dosing of conivaptan was effective in increasing free water excretion and correcting hyponatremia in neurologically ill patients. This supports its further evaluation for managing hyponatremia in this population.

journal_name

Neurocrit Care

journal_title

Neurocritical care

authors

Murphy T,Dhar R,Diringer M

doi

10.1007/s12028-008-9179-3

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

14-9

issue

1

eissn

1541-6933

issn

1556-0961

journal_volume

11

pub_type

杂志文章
  • Cerebral gumma mimicking glioblastoma multiforme.

    abstract::This article reports an unusual case of a syphilitic gumma with a clinical and radiographical presentation initially suggestive of glioblastoma multiforme. Pathological evaluation was essential in establishing the diagnosis of neurosyphilis and in excluding neoplastic involvement. Cerebral gumma should be considered a...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1385/NCC:2:3:300

    authors: Ances BM,Danish SF,Kolson DL,Judy KD,Liebeskind DS

    更新日期:2005-01-01 00:00:00

  • Emergency Neurological Life Support: Traumatic Spine Injury.

    abstract::Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using th...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-015-0169-y

    authors: Stein DM,Pineda JA,Roddy V,Knight WA 4th

    更新日期:2015-12-01 00:00:00

  • A Novel Cooling Device for Targeted Brain Temperature Control and Therapeutic Hypothermia: Feasibility Study in an Animal Model.

    abstract:BACKGROUND:Therapeutic hypothermia (i.e., temperature management) is an effective option for improving survival and neurological outcome after cardiac arrest and is potentially useful for the care of the critically ill neurological patient. We analyzed the feasibility of a device to control the temperature of the brain...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-016-0257-7

    authors: Giuliani E,Magnoni S,Fei M,Addis A,Zanasi R,Stocchetti N,Barbieri A

    更新日期:2016-12-01 00:00:00

  • Cerebrovascular Autoregulation Monitoring in the Management of Adult Severe Traumatic Brain Injury: A Delphi Consensus of Clinicians.

    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

    authors: Depreitere B,Citerio G,Smith M,Adelson PD,Aries MJ,Bleck TP,Bouzat P,Chesnut R,De Sloovere V,Diringer M,Dureanteau J,Ercole A,Hawryluk G,Hawthorne C,Helbok R,Klein SP,Neumann JO,Robba C,Steiner L,Stocchetti N,Tacc

    更新日期:2021-01-25 00:00:00

  • Methylene blue-associated serotonin syndrome: a 'green' encephalopathy after parathyroidectomy.

    abstract:INTRODUCTION:Methylene blue (MB) infusion is frequently used to localize the parathyroid glands during parathyroidectomy and generally considered safe. Several recent reports suggest neurological toxicity and post-operative altered mental state typically after large dose infusions. The mechanism by which MB has neuroto...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-009-9206-z

    authors: Rowley M,Riutort K,Shapiro D,Casler J,Festic E,Freeman WD

    更新日期:2009-01-01 00:00:00

  • Determinants of central sympathetic activation in spontaneous primary subarachnoid hemorrhage.

    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

    authors: Moussouttas M,Lai EW,Khoury J,Huynh TT,Dombrowski K,Pacak K

    更新日期:2012-06-01 00:00:00

  • Statins in the management of patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

    abstract:BACKGROUND:Delayed ischemic neurological deficits (DINDs) contribute to morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Based on promising preliminary reports, some clinicians routinely administer statins to prevent DINDs. METHODS:Without language restriction, we searched MEDLINE, EMBASE, t...

    journal_title:Neurocritical care

    pub_type: 杂志文章,meta分析,评审

    doi:10.1007/s12028-009-9306-9

    authors: Kramer AH,Fletcher JJ

    更新日期:2010-04-01 00:00:00

  • Early Mobilization in the Neuro-ICU: How Far Can We Go?

    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

    authors: Olkowski BF,Shah SO

    更新日期:2017-08-01 00:00:00

  • The Feasibility, Safety and Effectiveness of a Ketogenic Diet for Refractory Status Epilepticus in Adults in the Intensive Care Unit.

    abstract:BACKGROUND:Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU). METHODS:We...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-018-0653-2

    authors: Francis BA,Fillenworth J,Gorelick P,Karanec K,Tanner A

    更新日期:2019-06-01 00:00:00

  • Burst Suppression: Causes and Effects on Mortality in Critical Illness.

    abstract:BACKGROUND:Burst suppression in mechanically ventilated intensive care unit (ICU) patients is associated with increased mortality. However, the relative contributions of propofol use and critical illness itself to burst suppression; of burst suppression, propofol, and critical illness to mortality; and whether preventi...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-020-00932-4

    authors: Hogan J,Sun H,Aboul Nour H,Jing J,Tabaeizadeh M,Shoukat M,Javed F,Kassa S,Edhi MM,Bordbar E,Gallagher J,Junior VM,Ghanta M,Shao YP,Akeju O,Cole AJ,Rosenthal ES,Zafar S,Westover MB

    更新日期:2020-10-01 00:00:00

  • Effect of Desmopressin on Platelet Dysfunction During Antiplatelet Therapy: A Systematic Review.

    abstract:BACKGROUND AND OBJECTIVE:An increasing number of patients receive antiplatelet therapy. Patients exposed to surgery while receiving platelet inhibitors hold an increased bleeding risk. Especially in neurosurgery and neurocritical care patients, bleeding and hematoma expansion are feared complications as even minor blee...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-020-01055-6

    authors: Andersen LK,Hvas AM,Hvas CL

    更新日期:2020-08-04 00:00:00

  • Automated quantitative pupillometry for the prognostication of coma after cardiac arrest.

    abstract:BACKGROUND:Sedation and therapeutic hypothermia (TH) delay neurological responses and might reduce the accuracy of clinical examination to predict outcome after cardiac arrest (CA). We examined the accuracy of quantitative pupillary light reactivity (PLR), using an automated infrared pupillometry, to predict outcome of...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-014-9981-z

    authors: Suys T,Bouzat P,Marques-Vidal P,Sala N,Payen JF,Rossetti AO,Oddo M

    更新日期:2014-10-01 00:00:00

  • Advanced hemodynamic monitoring: principles and practice in neurocritical care.

    abstract::Advanced hemodynamic monitoring is necessary for many patients with acute brain and/or spinal cord injury. Optimizing cerebral and systemic physiology requires multi-organ system function monitoring. Hemodynamic manipulations are cardinal among interventions to regulate cerebral perfusion pressure and cerebral blood f...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-011-9568-x

    authors: Lazaridis C

    更新日期:2012-02-01 00:00:00

  • Infections in Neurocritical Care.

    abstract::Neurointensive care (NICU) patients experience complex infectious disease challenges. Central nervous system (CNS) infections are difficult to diagnose and treat, and post-neurosurgical patients are vulnerable to a unique set of healthcare-acquired infections (HAI) in addition to those typical of critically ill patien...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-017-0420-9

    authors: O'Horo JC,Sampathkumar P

    更新日期:2017-12-01 00:00:00

  • Controlled Hypercapnia Enhances Cerebral Blood Flow and Brain Tissue Oxygenation After Aneurysmal Subarachnoid Hemorrhage: Results of a Phase 1 Study.

    abstract:BACKGROUND:This study investigated if cerebral blood flow (CBF) regulation by changes of the arterial partial pressure of carbon dioxide (PaCO2) can be used therapeutically to increase CBF and improve neurological outcome after subarachnoid hemorrhage (SAH). METHODS:In 12 mechanically ventilated poor-grade SAH-patient...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-016-0246-x

    authors: Westermaier T,Stetter C,Kunze E,Willner N,Holzmeier J,Weiland J,Koehler S,Lotz C,Kilgenstein C,Ernestus RI,Roewer N,Muellenbach RM

    更新日期:2016-10-01 00:00:00

  • Artery of Percheron infarction as an unusual cause of coma: three cases and literature review.

    abstract:OBJECTIVE:Stroke due to occlusion of the artery of Percheron (AOP), an uncommon anatomic variant supplying the bilateral medial thalami, may raise diagnostic challenges and cause life-threatening symptoms. Our objective here was to detail the features and outcomes in three patients who required intensive care unit (ICU...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-014-9962-2

    authors: Zappella N,Merceron S,Nifle C,Hilly-Ginoux J,Bruneel F,Troché G,Cordoliani YS,Bedos JP,Pico F,Legriel S

    更新日期:2014-06-01 00:00:00

  • Timing of computed tomography and prediction of vasospasm after aneurysmal subarachnoid hemorrhage.

    abstract:BACKGROUND:The initial noncontrast computed tomography (CT) study of the head after an aneurysmal subarachnoid hemorrhage (SAH) is used to predict the risk of developing vasospasm. Changes in the extent of subarachnoid blood seen on CT images occur as a function of time after SAH, but there is no consensus on the time ...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-009-9227-7

    authors: Dupont SA,Wijdicks EF,Manno EM,Lanzino G,Brown RD Jr,Rabinstein AA

    更新日期:2009-01-01 00:00:00

  • Possibility of delayed cerebral infarction after pretruncal subarachnoid hemorrhage.

    abstract:BACKGROUND:A pretruncal subarachnoid hemorrhage has been accepted as a "benign" entity. Here we present two patients with delayed cerebral infarction following pretruncal subarachnoid hemorrhage. METHODS:Case report. RESULTS:Two patients with possible delayed cerebral infarction after pretruncal subarachnoid hemorrha...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-010-9403-9

    authors: Dupont SA,Rabinstein AA,Wijdicks EF,Lanzino G

    更新日期:2011-04-01 00:00:00

  • Therapy of intracranial hypertension in patients with fulminant hepatic failure.

    abstract::Severe intracranial hypertension (IH) in the setting of fulminant hepatic failure (FHF) carries a high mortality and is a challenging disease for the critical care provider. Despite considerable improvements in the understanding of the pathophysiology of cerebral edema during liver failure, therapeutic maneuvers that ...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1385/NCC:4:2:179

    authors: Raghavan M,Marik PE

    更新日期:2006-01-01 00:00:00

  • A bolus of conivaptan lowers intracranial pressure in a patient with hyponatremia after traumatic brain injury.

    abstract:BACKGROUND:Hyponatremia may complicate brain injury and exacerbate cerebral edema and intracranial pressure (ICP). Vasopressin-receptor antagonists (such as conivaptan) are promising novel agents to treat hyponatremia that act by inducing aquaresis. It is unclear whether raising serum sodium in this way could also conf...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-010-9366-x

    authors: Dhar R,Murphy-Human T

    更新日期:2011-02-01 00:00:00

  • Brain resuscitation in the drowning victim.

    abstract::Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide recommendations fo...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-012-9747-4

    authors: Topjian AA,Berg RA,Bierens JJ,Branche CM,Clark RS,Friberg H,Hoedemaekers CW,Holzer M,Katz LM,Knape JT,Kochanek PM,Nadkarni V,van der Hoeven JG,Warner DS

    更新日期:2012-12-01 00:00:00

  • Association of serum glucose concentrations during acute hospitalization with hematoma expansion, perihematomal edema, and three month outcome among patients with intracerebral hemorrhage.

    abstract:BACKGROUND:There is some evidence that hyperglycemia increases the rate of poor outcomes in patients with intracerebral hemorrhage (ICH). We explored the relationship between various parameters of serum glucose concentrations measured during acute hospitalization and hematoma expansion, perihematomal edema, and three m...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-011-9541-8

    authors: Qureshi AI,Palesch YY,Martin R,Novitzke J,Cruz-Flores S,Ehtisham A,Ezzeddine MA,Goldstein JN,Kirmani JF,Hussein HM,Suri MF,Tariq N,Liu Y,ATACH Investigators.

    更新日期:2011-12-01 00:00:00

  • The prognostic value of the EEG in postanoxic coma.

    abstract:INTRODUCTION:Several studies have been performed to assess the prognostic value of early neurological and neurophysiological findings in patients with postanoxic coma, but they have not led to precise, generally accepted, prognostic rules. This study was performed to assess whether it is possible to create a prognostic...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-008-9178-4

    authors: Roest A,van Bets B,Jorens PG,Baar I,Weyler J,Mercelis R

    更新日期:2009-01-01 00:00:00

  • Prolonged transcranial Doppler monitoring after aneurysmal subarachnoid hemorrhage fails to adequately predict ischemic risk.

    abstract:BACKGROUND:Stroke is common after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial Doppler ultrasound (TCD) monitoring is often employed to identify vasospasm and allow intervention to avoid infarction. The required duration of monitoring has not been established. We aim to determine if 10 days of TCD monitoring...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-011-9564-1

    authors: Miller CM,Palestrant D,Schievink WI,Alexander MJ

    更新日期:2011-12-01 00:00:00

  • MRI default mode network connectivity is associated with functional outcome after cardiopulmonary arrest.

    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

    authors: Koenig MA,Holt JL,Ernst T,Buchthal SD,Nakagawa K,Stenger VA,Chang L

    更新日期:2014-06-01 00:00:00

  • Heart-Shaped Bilateral Medullary Pyramidal Infarction as a Pathognomonic Finding of Anterior Spinal Artery Occlusion.

    abstract:BACKGROUND:Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS:Case reports and literature review. RESULTS:A 57-year-o...

    journal_title:Neurocritical care

    pub_type: 杂志文章,评审

    doi:10.1007/s12028-017-0406-7

    authors: Searcy S,Akinduro OO,Spector A,Yoon JW,Brown BL,Freeman WD

    更新日期:2018-06-01 00:00:00

  • Unilateral third nerve palsy caused by Guillain-Barré Syndrome.

    abstract:BACKGROUND:Highly asymmetric clinical signs in a patient suggest the need for caution in making the diagnosis of Guillain-Barré Syndrome (GBS). METHODS:Case report and literature review. We present a case of strictly unilateral left third cranial nerve palsy in a patient with GBS, review other highly asymmetrical cran...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1385/NCC:1:4:461

    authors: St Louis EK,Jacobson DM

    更新日期:2004-01-01 00:00:00

  • Safety, Feasibility, and Efficiency of a New Cooling Device Using Intravenous Cold Infusions for Fever Control.

    abstract:BACKGROUND:Fever control plays a key role in therapy of patients with acute brain injury. The infusion of cold saline could serve as an alternative or additional method for targeted temperature management. However, it is difficult to estimate the amount of fluid required to achieve normothermia merely on the basis of b...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-018-0588-7

    authors: Willms JF,Boss O,Keller E

    更新日期:2019-02-01 00:00:00

  • Acute epidural spinal hemorrhage from vasculitis: resolution with immunosuppression.

    abstract:BACKGROUND:Angiographic vasculitis affecting the spine has been rarely described. The use of immunosuppression as a primary treatment and a review of the literature is presented. METHODS:Case report. RESULTS:A 61-year-old female presented with sudden onset back pain and headache. The patient was found to have acute s...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-011-9667-8

    authors: Jacob JT,Tanaka S,Wood CP,Wijdicks EF,Lanzino G

    更新日期:2012-04-01 00:00:00

  • CTA spot sign predicts hematoma expansion in patients with delayed presentation after intracerebral hemorrhage.

    abstract:BACKGROUND:Hematoma expansion after acute intracerebral hemorrhage occurs most frequently in patients presenting within 3 h of symptom onset. However, the majority of patients present outside this window or with an unknown onset time. We investigated the prevalence of hematoma expansion in these patients and assessed t...

    journal_title:Neurocritical care

    pub_type: 杂志文章

    doi:10.1007/s12028-012-9765-2

    authors: Brouwers HB,Falcone GJ,McNamara KA,Ayres AM,Oleinik A,Schwab K,Romero JM,Viswanathan A,Greenberg SM,Rosand J,Goldstein JN

    更新日期:2012-12-01 00:00:00