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:Prospective observational study including 39 consecutive children undergoing heart surgery with cardiopulmonary bypass (CPB) and normal neurologic exam prior to surgery. Cerebral rSO2 was measured at baseline (prior to surgery) and then continuously during surgery and for the first 16 h post-operatively. Neuromarkers [neuron-specific enolase (NSE), S100β, glial fibrillary acidic protein (GFAP), and brain-derived neurotrophic factor (BDNF)] were measured in serum at baseline, immediately after CPB and at 16 h post-operatively. Adverse neurological outcome was defined as an abnormal pediatric cerebral performance category (PCPC) scale score at 12 months after surgery. RESULTS:Sixteen children (41 %) had an abnormal PCPC scale score at the 12-month evaluation after surgery. In children with unfavorable neurological outcomes, mean cerebral rSO2 values were lower and the area-under-the-curve below a threshold of 40 and 20% below baseline were also increased. No significant differences were found in serum neuromarkers between groups at the time points that were assessed. CONCLUSIONS:Bedside determination of cerebral rSO2 may have some utility in identifying children at risk for adverse neurological outcome after heart surgery in children. Additional studies that are sufficiently powered to control for the many covariates in this patient population will be required to fully interrogate this important question. The role of serum neuromarkers in the immediate post-operative period do not appear to be helpful in this question, though more thorough interrogation of delayed periods may ultimately demonstrate some utility in answering this question.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Sanchez-de-Toledo J,Chrysostomou C,Munoz R,Lichtenstein S,Sao-Avilés CA,Wearden PD,Morell VO,Clark RS,Toney N,Bell MJdoi
10.1007/s12028-013-9934-ysubject
Has Abstractpub_date
2014-08-01 00:00:00pages
133-9issue
1eissn
1541-6933issn
1556-0961journal_volume
21pub_type
杂志文章abstract:BACKGROUND:Release of cardiac biomarkers is reported in patients with subarachnoid hemorrhage (SAH). Data addressing the impact of cardiac injury on outcome in these patients is sparse. This study was conducted to ascertain the association of elevation of serum cardiac Troponin-I (cTnI) with mortality and neurological ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9038-7
更新日期:2008-01-01 00:00:00
abstract:INTRODUCTION:The treatment and outcomes of heparin-induced thrombocytopenia (HIT) are not well described in neurosurgery patients. This study reviewed the treatment for HIT in subarachnoid hemorrhage (SAH) patients, and compared outcomes in patients with isolated HIT (iHIT) and HIT with thrombotic syndrome (HITTS). ME...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9725-x
更新日期:2012-10-01 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::Drug shortages have become all too familiar in the health care environment, with over 200 drugs currently on shortage. In the wake of Hurricane Maria in September 2017, hospitals across the USA had to quickly and creatively adjust medication preparation and administration techniques in light of decreased availability ...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-019-00730-7
更新日期:2020-02-01 00:00:00
abstract::Neuromuscular disorders increasingly are recognized as a complication in patients in the intensive care unit (ICU) and represent a common cause of prolonged ventilator dependency. The distinct syndromes of critical illness myopathy, prolonged neuromuscular blockade, and critical illness polyneuropathy (CIP) may arise ...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1385/NCC:3:3:195
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Stereotactic minimally invasive surgery (sMIS) has been used in the treatment of intracerebral hemorrhage (ICH) in recent years and has obtained promising results. However, the outcomes of patients are associated with many factors. The aim of the present study was to retrospectively observe the relationship ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-00996-2
更新日期:2020-05-27 00:00:00
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
更新日期:2017-12-01 00:00:00
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
更新日期:2010-04-01 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: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::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
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Target blood pressure (BP) in stable (non-hypotensive) patients with acute isolated blunt traumatic intracranial hemorrhage (TICH) is unknown. To address this issue, our study correlated BP with radiological volumetric progression (RP) and neurological deterioration (ND) in these patients. METHODS:A retrosp...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9957-z
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Knowing the individual child's risk is highly useful when deciding on treatment strategies, especially when deciding on invasive procedures. In this study, we aimed to develop a new predictive score for children with bacterial meningitis and compare this with existing predictive scores and individual risk fa...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00792-7
更新日期:2020-04-01 00:00:00
abstract:: ...
journal_title:Neurocritical care
pub_type: 评论,信件
doi:10.1007/s12028-018-0605-x
更新日期:2018-12-01 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::Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:4:1:018
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Acute hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH); however, attempts to predict shunt-dependent chronic hydrocephalus using clinical parameters have been equivocal. METHODS:Cohort study of aSAH is treated with external ventricular drainage (EVD) placement at our insti...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00886-2
更新日期:2020-08-01 00:00:00
abstract:: ...
journal_title:Neurocritical care
pub_type: 评论,信件
doi:10.1007/s12028-018-0664-z
更新日期:2019-04-01 00:00:00
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
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Takotsubo syndrome is a reversible neuromyocardial failure that has been thought to be related to an acute catecholamine toxicity of the myocardium brought upon by a stressful event. The neurocritical care unit population is particularly vulnerable for this condition given the acute presentation of neurologi...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9075-x
更新日期:2008-01-01 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:INTRODUCTION:Airembolism without obvious trauma or surgery is rare. METHODS:Case report. RESULTS:Four years after resection of a non-small cell lung cancer, a 57-year-old man presented with recurrent episodes of sudden onset neurological deficits. Head computer tomographic (CT) scans suggested air embolism, and furth...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9073-z
更新日期:2008-01-01 00:00:00
abstract::The Fifth Neurocritical Care Research Network (NCRN) Conference held in Boca Raton, Florida, in September of 2018 was devoted to challenging the current status quo and examining the role of the Neurocritical Care Society (NCS) in driving the science and research of neurocritical care. The aim of this in-person meeting...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00767-8
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Cerebral edema is a major cause of mortality following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Arginine vasopressin (AVP) and water channel aquaporin-4 (AQP4) have been implicated in the pathogenesis of CA-evoked cerebral edema. In this study, we examined if conivaptan, a V1a and V2 anta...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0236-4
更新日期:2016-04-01 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:: ...
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:Currently, continuous electroencephalographic monitoring (cEEG) is the only available diagnostic tool for continuous monitoring of brain function in intensive care unit (ICU) patients. Yet, the exact relevance of routinely applied ICU cEEG remains unclear, and information on the implementation of cEEG, espec...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0525-9
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Over-the-counter herbal and alternative medicines are classified as dietary supplements and, unlike drugs, are not rigorously regulated by the United States Food and Drug Administration. Their potential adverse effects are often poorly characterized. METHOD:Red clover, dong quai, and Siberian ginseng are ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0075-z
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Hypothermic brain protection has been linked to how rapidly cooling is initiated and how quickly and uniformly the therapeutic hypothermic zone (THZ) is reached. The nasopharyngeal (NP) approach is uniquely suited for preferential brain cooling due to anatomic proximity to the cerebral circulation, caverno...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9064-0
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Early diagnostic orientation for differentiating pneumonia from pneumonitis at the early stage after aspiration would be valuable to avoid unnecessary antibiotic therapy. We assessed the accuracy of procalcitonin (PCT) in diagnosing aspiration pneumonia (AP) in intensive care unit (ICU) patients requiring me...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0623-8
更新日期:2019-04-01 00:00:00