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 available data was undertaken, with special consideration given to values of intracranial pressure (ICP), cerebral perfusion pressure (CPP) and oxygenation in correlation to prone (PP), or supine positioning (SP) of patients. Cases were considered eligible if kinetic therapy and ICP were documented. Prone positioning was performed in a 135° position for 8 h per treatment unit. RESULTS:A total of 115 patients treated with prone positioning from 2007 to 2013 were identified in our medical records. Of these, 29 patients received ICP monitoring. Overall, 119 treatment units of prone positioning with a mean duration of 2.5 days per patient were performed. The mean baseline ICP in SP was 9.5 ± 5.9 mmHg and was increased significantly during PP (p < 0.0001). There was no significant difference between CPP in SP (82 ± 14.5 mmHg) compared to PP (p > 0.05). ICP values >20 mmHg occurred more often during PP than SP (p < 0.0001) and were associated with significantly more episodes of decreased CPP <70 mmHg (p < 0.0022). The mean paO(2)/FiO(2) ratio (P/F ratio) was increased significantly in prone positioning of patients (p < 0.0001). CONCLUSIONS:The analyzed data allow a more precise understanding of changes in ICP and oxygenation during prone positioning in patients with acute brain injury and almost normal baseline ICP. Our study shows a moderate, yet significant elevation of ICP during prone positioning. However, the achieved increase of oxygenation by far exceeded the changes in ICP. It is evident that continuous monitoring of cerebral pressure is required in this patient group.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Roth C,Ferbert A,Deinsberger W,Kleffmann J,Kästner S,Godau J,Schüler M,Tryba M,Gehling Mdoi
10.1007/s12028-014-0004-xsubject
Has Abstractpub_date
2014-10-01 00:00:00pages
186-91issue
2eissn
1541-6933issn
1556-0961journal_volume
21pub_type
临床试验,杂志文章abstract:PURPOSE:One study found higher leukocytes 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in patients with spontaneous intracerebral hemorrhage (ICH) than in healthy subjects due to the oxidation of guanosine from deoxyribonucleic acid (DNA). The objective of this study was to determine whether there is an association betw...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00864-8
更新日期:2020-08-01 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: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: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: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
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: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::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: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
abstract:BACKGROUND:Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9490-7
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:This prospective study of an innovative non-invasive ultrasonic cerebrovascular autoregulation (CA) monitoring method is based on real-time measurements of intracranial blood volume (IBV) reactions following changes in arterial blood pressure. In this study, we aimed to determine the clinical applicability o...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0569-x
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:Prophylactic treatment with antiepileptic drugs is common practice following subarachnoid hemorrhage (SAH) and traumatic brain injury. However, commonly used antiepileptic drugs have multiple drug interactions, require frequent monitoring of serum levels, and are associated with adverse effects that may prom...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:1:71
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To summarize trends in status epilepticus (SE) in the United States by age, race, sex, admission source, disposition, incidence rates, and mortality. METHODS:Data from US National Hospital Discharge Survey were used from 1979 to 2010 to identify discharges with SE and common etiologies and complications of S...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9935-x
更新日期:2014-06-01 00:00:00
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
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients with acute brain injuries require strict physiologic control to minimize morbidity and mortality. This study aimed to assess in-hospital compliance to strict physiologic parameters (BP, HR, ICP, SpO2) in these populations. METHODS:Patients with severe cerebrovascular events were admitte...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0116-y
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Rapid diagnosis and proper management of intracerebral hemorrhage (ICH) play a crucial role in the outcome. Prediction of the outcome with a high degree of accuracy based on admission data including imaging information can potentially influence clinical decision-making practice. METHODS:We conducted a retro...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00783-8
更新日期:2020-04-01 00:00:00
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
更新日期:2019-06-01 00:00:00
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
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:The importance of preoperative response to external ventricular drainage (EVD) for treatment of acute hydrocephalus (HCP) following poor grade (Hunt & Hess grade IV or V) aneurysmal subarachnoid hemorrhage (aSAH) has not been clearly defined. The effect of EVD response on preoperative grade and prognosis i...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0019-7
更新日期:2007-01-01 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::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: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:: ...
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:Terson's syndrome is intraocular hemorrhage (IOH) subsequent to subarachnoid hemorrhage (SAH). Its presence is associated with higher mortality in SAH. We report a case of Terson's syndrome and review the literature. CASE REPORT:A 71-year-old Caucasian gentleman collapsed and became comatose. Past medical h...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9555-2
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:No proven treatments exist for intracerebral hemorrhage (ICH). Carefully selected patients may benefit from surgery, and an international multicenter trial is ongoing. We sought to determine how many patients in a population-based ICH cohort would have been eligible for surgery using the Surgical Trial in ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9045-8
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:There are some intracranial insults which are associated with cardiac abnormalities. Studies of these abnormalities have never been carried out in elective intracranial neurosurgery for the removal of brain tumors. Our prospective study aims at quantifying serum cardiac troponin T (cTnT) and N-terminal pro-b...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9684-2
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Attitudes toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in space-occupying middle cerebral artery stroke (SOS). The attitudes of nurses deserve strong attention, because of their close interaction with patients during ...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-018-0586-9
更新日期:2019-02-01 00:00:00
abstract::The presence of pulmonary dysfunction after brain injury is well recognized. Acute lung injury (ALI) occurs in 20% of patients with isolated brain injury and is associated with a poor outcome. The "blast injury" theory, which proposes combined "hydrostatic" and "high permeability" mechanisms for the formation of neuro...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-009-9242-8
更新日期:2009-12-01 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