Abstract：
BACKGROUND:Improvements in technology play an important role in caring for critically ill patients. One example is the advance in ventilator design to facilitate triggering of mechanical breaths. Minimal changes in circuit flow unrelated to respiratory effort can trigger a ventilator breath and may mislead caregivers in recognizing brain death. METHODS:We observed patients with devastating brain injuries in a mixed medical/surgical intensive care unit (ICU) with a high clinical suspicion for brain death including the absence of cranial nerve function with apparent spontaneous breathing during patient-triggered modes of mechanical ventilation. Further clinical observation for spontaneous respirations was assessed upon removal of ventilatory support. RESULTS:Nine patients with brain injury due to multiple etiologies were identified and demonstrated no spontaneous respirations when formally assessed for apnea. Length of time between brain death and its recognition could not be determined. CONCLUSION:When brain-dead patients who are suitable organ donors are mistakenly identified as having cerebral activity, the diagnosis of brain death is delayed. This delay impacts resource utilization, impedes recovery and function of organs for donation, and adversely affects donor families, potential recipients of organs, and patient donors who may have testing and treatment that cannot be beneficial. Patients with catastrophic brain injury and absent cranial nerve function should undergo immediate formal apnea testing.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
McGee WT,Mailloux Pdoi
10.1007/s12028-010-9491-6subject
Has Abstractpub_date
2011-04-01 00:00:00pages
267-71issue
2eissn
1541-6933issn
1556-0961journal_volume
14pub_type
杂志文章abstract：BACKGROUND:Physiological reactions of the stress hormone cortisol include hyperglycemia, hypertension, and endothelium dysfunction. In patients with aneurysmal subarachnoid hemorrhage (SAH), hyperglycemia, hypertension, and endothelium dysfunction are associated with the occurrence of delayed cerebral ischemia (DCI). T...
journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-010-9331-8
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:In several instances, the diagnosis of brain death has been questioned due to the presence of movements. This case report and review of the literature illustrates the spectrum of movements that have been encountered in brain death. METHODS:A case report and review of the literature on movements seen in brai...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:3:2:122
更新日期：2005-01-01 00:00:00
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
更新日期：2018-06-01 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
abstract：BACKGROUND:Fever is associated with worse outcome after intracerebral hemorrhage (ICH). Autonomic dysfunction, commonly seen after brain injury, results in reduced heart rate variability (HRV). We sought to investigate whether HRV was associated with the development of fever in patients with ICH. METHODS:We prospectiv...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00684-w
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:The indications for bevacizumab (a vascular endothelial growth factor inhibitor) have been expanded recently. Despite concerns for cerebrovascular events from bevacizumab treatment, detailed clinical and radiologic information are lacking. METHODS:Using the Mayo Clinic Rochester database (January 2006-Septe...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9552-5
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to ev...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1007/s12028-010-9451-1
更新日期：2011-08-01 00:00:00
abstract：:A growing body of clinical literature emphasizes the impact of cerebral edema in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). Aneurysm rupture itself initiates global cerebral edema in up to two thirds of cases. Although cerebral edema is not a universal feature of aSAH, it portends a poor c...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-016-0354-7
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND AND PURPOSE:Stress-induced hyperglycemia (SIH) is the relative transient increase in glucose during a critical illness such as intracerebral hemorrhage (ICH) and is likely to play an important role in the pathogenesis of remote diffusion-weighted imaging (DWI) lesion (R-DWIL) in primary ICH. We sought to det...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00747-y
更新日期：2020-04-01 00:00:00
abstract：BACKGROUND:Early recognition and treatment of autoimmune encephalitis (AE) has become an essential issue in clinical practice. However, little is known about patients with deteriorating conditions and the need for intensive care treatment. Here, we aimed to characterize underlying aetiologies, clinical symptoms, reason...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0370-7
更新日期：2017-08-01 00:00:00
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
更新日期：2004-01-01 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：:Stroke in pregnant women has a mortality rate of 1.4 deaths per 100,000 deliveries. Vascular malformations are the most common cause of hemorrhagic stroke in this population; preeclampsia and other risk factors have been identified. However, nearly a quarter of strokes have an undeterminable cause. Spontaneous intracr...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0501-4
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND/OBJECTIVE:Infection is the most common complication of external ventricular drain (EVD) placement. National trends in the annual incidence of meningitis among patients with traumatic brain injury (TBI) who have undergone EVD placement have not been reported. METHODS:The Nationwide Inpatient Sample was used ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0656-z
更新日期：2019-06-01 00:00:00
abstract：BACKGROUND:Lymphopenia is increasingly recognized as a consequence of acute illness and may predispose to infections. We investigated whether admission lymphopenia (AL) is associated with increased risk of infectious complications and poor outcome in patients with spontaneous intracerebral hemorrhage (ICH). METHODS:We...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0367-2
更新日期：2017-04-01 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:Noncontrast computed tomography (CT) markers are increasingly used for predicting hematoma expansion. The aim of our study was to investigate the predictive value of expansion-prone hematoma in predicting hematoma expansion and outcome in patients with intracerebral hemorrhage (ICH). METHODS:Between July 20...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0644-3
更新日期：2019-06-01 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：BACKGROUND:The aim of this study is to determine the utility of non-invasive bedside neuromonitoring, including cerebral regional oxygen saturation (rSO2) measured by near-infrared spectroscopy and serum biomarkers, in identifying children at risk from adverse neurological outcome after heart surgery. METHODS:Prospect...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9934-y
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:The primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando,...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-015-0148-3
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:The management of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) can be often complicated by the presence of stunned myocardium and left ventricular failure. Vasopressors and inotropes are commonly used to optimize mean arterial pressure (MAP) and cerebral perfusion pressure (...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-010-9358-x
更新日期：2010-08-01 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:To date, common therapy in patients with intracranial hemorrhage (ICH) includes prophylaxis of seizure using antiepileptic drugs, commonly phenytoin. Phenytoin therapy is associated with a high incidence of cognitive disturbance. Levetiracetam is known to cause less cognitive disruption and may be a suitable...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9341-6
更新日期：2011-08-01 00:00:00
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
更新日期：2011-12-01 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:Direct invasive monitoring of brain tissue oxygenation (PbtO(2)) has been routinely utilized to predict cerebral ischemia and to prevent secondary injury in patients with traumatic brain injury (TBI) and vasospasm secondary to subarachnoid hemorrhage (SAH). The safety and utility of these devices in the pedi...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9531-x
更新日期：2011-12-01 00:00:00
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：:Acute ischemic stroke is a neurological emergency that can be treated with time-sensitive interventions, including both intravenous thrombolysis and endovascular approaches to thrombus removal. Extensive study has demonstrated that rapid, protocolized, assessment and treatment is essential to improving neurological ou...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-017-0449-9
更新日期：2017-09-01 00:00:00
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 a...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-9020-4
更新日期：2008-01-01 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
