Abstract：
BACKGROUND AND PURPOSE:In patients with subarachnoid hemorrhage (SAH), higher hemoglobin (HGB) has been associated with better outcomes, but packed red blood cell (PRBC) transfusions with worse outcomes. We performed a prospective pilot trial of goal HGB after SAH. METHODS:Forty-four patients with SAH and high risk for vasospasm were randomized to goal HGB concentration of at least 10 or 11.5 g/dl. We obtained blinded clinical outcomes at 14 days (NIH Stroke Scale and modified Rankin Scale, mRS), 28 days (mRS), and 3 months (mRS), and blinded interpretation of brain MRI for cerebral infarction at 14 days. This trial is registered at www.stroketrials.org. RESULTS:Forty-four patients were randomized. Patients with goal HGB 11.5 g/dl received more PRBC units per transfusion [1 (1-2) vs. 1 (1-1), P < 0.001] and more total PRBC units [3 (2-4) vs. 2 (1-3), P = 0.045]. Prospectively defined safety endpoints were not different between groups. HGB concentration was different between study groups from day 4 onwards. The number of cerebral infarctions on MRI (6 of 20 vs. 9 of 22), NIH Stroke Scale scores at 14 days [1 (0-9.75) vs. 2 (0-16)], and rates of independence on the mRS at 14 days (65% vs. 44%) and 28 days (80% vs. 67%) were similar, but favored higher goal HGB (P > 0.1 for all). CONCLUSIONS:Higher goal hemoglobin in patients with SAH seems to be safe and feasible. A phase III trial of goal HGB after SAH is warranted.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Naidech AM,Shaibani A,Garg RK,Duran IM,Liebling SM,Bassin SL,Bendok BR,Bernstein RA,Batjer HH,Alberts MJdoi
10.1007/s12028-010-9424-4subject
Has Abstractpub_date
2010-12-01 00:00:00pages
313-20issue
3eissn
1541-6933issn
1556-0961journal_volume
13pub_type
杂志文章,随机对照试验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
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:Patients on neurological intensive care units (NICU) who require ventilatory support often suffer from co-existing bulbar dysfunction, either because of their underlying disease or because of their decreased level of consciousness. For this reason, most patients are ventilated through a cuffed tracheostomy...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1007/s12028-007-0024-x
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Acute bilateral acute carotid arteries occlusion is a very rare condition. We describe a patient with initial right middle cerebral artery syndrome who developed coma and quadriplegia 1 h after thrombolysis with intravenous tPA and was found to have bilateral cervical internal carotid artery occlusion. ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0076-y
更新日期：2007-01-01 00:00:00
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
更新日期：2019-02-01 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：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
更新日期：2014-06-01 00:00:00
abstract：INTRODUCTION:To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use. METHODS:A device with oriented microfilaments was constructed that consists of a core wires compound surrounded by a dense palisade of perpendicular-oriented stiff polya...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:5:2:134
更新日期：2006-01-01 00:00:00
abstract：INTRODUCTION:Cerebral vasospasm in aneurysmal subarachnoid hemorrhage (SAH) is associated with poor outcome. The safety and feasibility of continuous high-dose intravenous magnesium sulfate (MgSO4) for the prevention of cerebral vasospasm and ischemic cerebral injury has not been well studied. METHODS:Patients present...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1385/NCC:3:1:016
更新日期：2005-01-01 00:00:00
abstract：INTRODUCTION:Delayed ischemic neurologic deficits secondary to vasospasm are a major cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Treatment of vasospasm after SAH is associated with complications, and reliable techniques for evaluating effects of treatment of vasospasm in such patients are warr...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/ncc:6:1:40
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Hydrocephalus with normal intracranial pressure has rarely been reported to result in herniation. METHODS:Case report. RESULTS:A 52-year-old man became acutely comatose with extensor posturing and ventriculomegaly 17 days after experiencing a primary ventricular hemorrhage. An external ventricular drain ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:2:2:172
更新日期：2005-01-01 00:00:00
abstract：:A common observation in closed head injuries is the contrecoup brain injury. As the in vivo brain is less dense than the cerebrospinal fluid (CSF), one hypothesis explaining this observation is that upon skull impact, the denser CSF moves toward the site of skull impact displacing the brain in the opposite direction, ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:1:3:385
更新日期：2004-01-01 00:00:00
abstract：INTRODUCTION:Status epilepticus remains a life-threatening condition that afflicts both adults and children which although occurs in patients with epilepsy, often presents as new-onset seizure activity also. Refractory status epilepticus poses a management challenge for neurological and neurosurgical teams. CASE REPOR...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0038-4
更新日期：2007-01-01 00:00:00
abstract：INTRODUCTION:Malignant cerebral edema develops in a small subset of patients with hemispheric strokes, precipitating deterioration and death if decompressive hemicraniectomy (DHC) is not performed in a timely manner. Predicting which stroke patients will develop malignant edema is imprecise based on clinical data alone...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-020-01056-5
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:Long-term studies of survivors of acute respiratory distress syndrome (ARDS) have reported neuromuscular, quality of life, and neuropsychological impairments. This study aims to determine if development of ARDS was associated with neuromuscular weakness and depression at 6-month following hospital discharge ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-0087-4
更新日期：2015-06-01 00:00:00
abstract：BACKGROUND:Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9727-8
更新日期：2014-02-01 00:00:00
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
更新日期：2020-08-04 00:00:00
abstract：BACKGROUND:There is no uniform definition for cerebral microdialysis (CMD) probe location with respect to focal brain lesions, and the impact of CMD-probe location on measured molecule concentrations is unclear. METHODS:We retrospectively analyzed data of 51 consecutive subarachnoid hemorrhage patients with CMD-monito...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00713-8
更新日期：2020-02-01 00:00:00
abstract：: ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0585-x
更新日期：2019-04-01 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:Intra-arterial (IA) nicardipine is often used to treat cerebral vasospasm associated with subarachnoid hemorrhage (SAH). While hypotension has been noted to be a dose-limiting side effect of intravenous infusions, this has seldom been reported for IA administration. METHODS:We reviewed a consecutive series ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9537-4
更新日期：2011-12-01 00:00:00
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
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:An alternation of sympathetic and vagal nervous activity has been suggested to be one possible mechanism of neurogenic pulmonary edema (NPE) in patients with subarachnoid hemorrhage (SAH). The study aimed to explore if sympathovagal modulation assessed by frequency domains of heart rate variability (HRV) is ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-015-0237-3
更新日期：2016-08-01 00:00:00
abstract：INTRODUCTION:Patients with acute neurological illness may be hypercatabolic. The Harris-Benedict Equation (HBE) is used to estimate energy needs in acute stroke. A "stress factor" for stroke does not exist, and it is not known if the HBE accurately estimates the energy expenditure needs in acute ischemic or hemorrhagic...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:1:3:331
更新日期：2004-01-01 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：:Acute liver failure (ALF), the abrupt loss of liver function in a patient without previous liver disease, remains a highly mortal condition. Patients with ALF often succumb to their liver injury after the development of cerebral edema, resulting in intracranial hypertension and brain herniation. While the management o...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-008-9090-y
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Median nerve short-latency somatosensory evoked potentials (SSEPs) are useful in determining prognosis for awakening after coma following hypoxic ischemic encephalopathy, but reliability of interpretation is unclear. OBJECTIVE:To measure inter- and intra-observer reliability of determining presence or absen...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9251-7
更新日期：2009-12-01 00:00:00
abstract：INTRODUCTION:The apnea test is a crucial component of the clinical diagnosis of brain death. Apprehension about hypoxemia, hypotension, and/or cardiac arrhythmias may sometimes lead clinicians to avoid performing or prematurely terminate the apnea test. The purpose of this study was to perform a contemporary re-evaluat...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-9958-y
更新日期：2014-12-01 00:00:00
abstract：:An elevated platelet count may occur during care of neurology/neurosurgical patients and is usually due to reactive or secondary thrombocytosis (ST) caused by inflammation or infection. Primary (clonal) thrombocythemia or essential thrombocythemia associated with myeloproliferative disorders is usually known before or...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-008-9076-9
更新日期：2008-01-01 00:00:00
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
更新日期：2014-10-01 00:00:00
abstract：INTRODUCTION:A case of cefepime-induced nonconvulsive status epilepticus in a 15-year-old child with end stage renal disease on hemodialysis is reported. Clinical symptoms and EEG dramatically improved 48 h after discontinuation of cefepime. METHODS:Twenty-five cases of nonconvulsive status epilepticus associated with...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-008-9166-8
更新日期：2009-01-01 00:00:00
