Abstract：
BACKGROUND:This prospective consecutive double-blinded randomized study investigated the effect of prostacyclin on pressure reactivity (PR) in severe traumatic brain injured patients. Other aims were to describe PR over time and its relation to outcome. METHODS:Blunt head trauma patients, Glasgow coma scale ≤8, age 15-70 years were included and randomized to prostacyclin treatment (n = 23) or placebo (n = 25). Outcome was assessed using the extended Glasgow outcome scale (GOSE) at 3 months. PR was calculated as the regression coefficient between the hourly mean values of ICP versus MAP. Pressure active/stable was defined as PR ≤0. RESULTS:Mean PR over 96 h (PRtot) was 0.077 ± 0.168, in the prostacyclin group 0.030 ± 0.153 and in the placebo group 0.120 ± 0.173 (p < 0.02). There was a larger portion of pressure-active/stable patients in the prostacyclin group than in the placebo group (p < 0.05). Intra-individual changes over time were common. PRtot correlated negatively with GOSE score (p < 0.04). PRtot was 0.117 ± 0.182 in the unfavorable (GOSE 1-4) and 0.029 ± 0.140 in the favorable outcome group (GOSE 5-8). Area under the curve for prediction of death (ROC) was 0.742 and for favorable outcome 0.628. CONCLUSIONS:Prostacyclin influenced the PR in a direction of increased pressure stability and a lower PRtot was associated with improved outcome. The individual PR varied substantially over time. The predictive value of PRtot for outcome was not solid enough to be used in the clinical situation.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Koskinen LO,Eklund A,Sundström N,Olivecrona Mdoi
10.1007/s12028-014-0030-8subject
Has Abstractpub_date
2015-02-01 00:00:00pages
26-33issue
1eissn
1541-6933issn
1556-0961journal_volume
22pub_type
杂志文章,随机对照试验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：: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:Abusive head trauma (AHT) is a common condition in children. Little is known in this condition regarding the frequency of seizures, the factors associated with increased risk of seizures, or the association of seizures with outcome. We sought to determine frequency and risks for in-hospital seizures after AH...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9468-5
更新日期：2011-08-01 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：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：BACKGROUND:The objectives of this study were to determine effects of severe traumatic brain injury (TBI) on cerebrospinal fluid (CSF) concentrations of myelin basic protein (MBP) and to assess relationships between clinical variables and CSF MBP concentrations. METHODS:We measured serial CSF MBP concentrations in chil...
journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-012-9767-0
更新日期：2012-12-01 00:00:00
abstract：:We now recognize that the main breathing generator resides principally in the medulla oblongata. Vivisectionists-specifically, Julien Legallois-discovered "the respiratory center." Cutting through the brainstem stops respiration but not if the medulla remains intact and the brain is sliced in successive portions. Pier...
journal_title：Neurocritical care
pub_type： 历史文章,杂志文章
doi：10.1007/s12028-019-00686-8
更新日期：2019-08-01 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：:Subarachnoid hemorrhage (SAH) is a neurological emergency because it may lead to sudden neurological decline and death and, depending on the cause, has treatment options that can return a patient to normal. Because there are interventions that can be life-saving in the first hour of onset, SAH was chosen as an Emergen...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-012-9761-6
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:To determine the clinical characteristics and outcomes of patients with neurogenic stress cardiomyopathy (NSC) among patients admitted to our neuroscience intensive care unit (NICU). METHODS:Following institutional review board approval, consecutive adult patients admitted to the NICU between 2009 and 2013 w...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-017-0412-9
更新日期：2017-12-01 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：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:The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. METHODS:This is a retrospective analysis of data from a pros...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-015-0138-5
更新日期：2015-12-01 00:00:00
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
更新日期：2014-06-01 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：:Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarac...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-011-9593-9
更新日期：2011-09-01 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:Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. NPE usually appears within minutes to hours after injury and has a high mortality rate if not recognized and treated appropriately. Lung ultrasound quickly provides at the b...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9828-z
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:Global cerebral edema (GCE) with subsequent refractory intracranial hypertension complicates some cases of aneurysmal subarachnoid hemorrhage (aSAH), and typically is associated with poorer outcome. Treatment options for refractory intracranial pressure (ICP) cases are limited to decompressive hemicraniectom...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-9989-4
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND AND AIMS:Lipid peroxidation represents a marker of secondary brain injury both in traumatic and in non-traumatic conditions-as in major neurosurgical procedures-eventually leading to brain edema amplification and further brain damage. Malondialdehyde (MDA), a lipid peroxidation marker, and ascorbate, a marke...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00870-w
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Infection in the intensive care unit (ICU) empirically requires broad-spectrum antibiotics. Imipenem/cilastatin, often reserved for more serious hospital-acquired infections, is thought to be associated with a higher risk of seizures than other penicillins and carbapenems. We sought to evaluate the safety of...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-008-9170-z
更新日期：2009-01-01 00:00:00
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
更新日期：2012-12-01 00:00:00
abstract：INTRODUCTION:A 38-year-old man with severe head trauma complicated by paroxysmal severe intracranial pressure elevation associated with tachypnea, tachycardia, diaphoresis, and extensor posturing was diagnosed as suffering from paroxysmal autonomic instability with dystonia (PAID). These events were unresponsive to sta...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0066-0
更新日期：2007-01-01 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: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, whic...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9179-3
更新日期：2009-01-01 00:00:00
abstract：INTRODUCTION:It is unclear whether the rate of stimulation for somatosensory evoked potentials (SEPs) can influence the presence or absence of cortical responses to median nerve stimulation in comatose patients. If so, this could affect how SEPs are performed and interpreted for prognostication in coma. Our objective w...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9191-2
更新日期：2010-02-01 00:00:00
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
更新日期：2012-06-01 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: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：INTRODUCTION:Altered mental status and more subtle cognitive and personality changes after traumatic brain injury (TBI) are pervasive problems in patients who survive initial injury. MRI is not necessarily part of the diagnostic evaluation of these patients. METHODS:Case report with relevant image and review of the li...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-012-9699-8
更新日期：2012-06-01 00:00:00
