Abstract：
BACKGROUND:This study investigated if cerebral blood flow (CBF) regulation by changes of the arterial partial pressure of carbon dioxide (PaCO2) can be used therapeutically to increase CBF and improve neurological outcome after subarachnoid hemorrhage (SAH). METHODS:In 12 mechanically ventilated poor-grade SAH-patients, a daily trial intervention was performed between day 4 and 14. During this intervention, PaCO2 was decreased to 30 mmHg and then gradually increased to 40, 50, and 60 mmHg in 15-min intervals by modifications of the respiratory minute volume. CBF and brain tissue oxygen saturation (StiO2) were the primary and secondary endpoints. Intracranial pressure was controlled by an external ventricular drainage. RESULTS:CBF reproducibly decreased during hyperventilation and increased to a maximum of 141 ± 53 % of baseline during hypercapnia (PaCO2 60 mmHg) on all days between day 4 and 14 after SAH. Similarly, StiO2 increased during hypercapnia. CBF remained elevated within the first hour after resetting ventilation to baseline parameters and no rebound effect was observed within this time-span. PaCO2-reactivities of CBF and StiO2 were highest between 30 and 50 mmHg and slightly decreased at higher levels. CONCLUSION:CBF and StiO2 reproducibly increased by controlled hypercapnia of up to 60 mmHg even during the period of the maximum expected vasospasm. The absence of a rebound effect within the first hour after hypercapnia indicates that an improvement of the protocol is possible. The intervention may yield a therapeutic potential to prevent ischemic deficits after aneurysmal SAH.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Westermaier T,Stetter C,Kunze E,Willner N,Holzmeier J,Weiland J,Koehler S,Lotz C,Kilgenstein C,Ernestus RI,Roewer N,Muellenbach RMdoi
10.1007/s12028-016-0246-xsubject
Has Abstractpub_date
2016-10-01 00:00:00pages
205-14issue
2eissn
1541-6933issn
1556-0961pii
10.1007/s12028-016-0246-xjournal_volume
25pub_type
杂志文章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:Intrahospital transport is associated with a high rate of complications. Investigations of this problem using neuromonitoring remain scarce. METHODS:This is a monocentric, prospective observational study. Patients with severe brain diseases and intracranial pressure (ICP) monitoring were included. Continuou...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0274-6
更新日期：2016-12-01 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
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0054-4
更新日期：2007-01-01 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：INTRODUCTION:Effective treatment for severe ischemic stroke continues to be largely an unmet medical need. Using a nonvascular (paravascular cerebrospinal fluid) pathway to provide oxygen and nutrients to ischemic tissues may be a means of treating this disease. The primary objective of this study was to evaluate the s...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:5:1:21
更新日期：2006-01-01 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: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：BACKGROUND:Diagnosis of intensive care unit acquired weakness (ICUAW) is challenging. Pathogenesis of underlying critical illness polyneuromyopathy (CIPNM) remains incompletely understood. This exploratory study investigated whether longitudinal neuromuscular ultrasound examinations and cytokine analyses in correlation...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-020-01148-2
更新日期：2020-11-24 00:00:00
abstract：BACKGROUND:In the postpartum patient, sudden depression of consciousness may be caused by a number of etiologies and can result in serious consequences. Rapid, accurate diagnosis allows for specific treatments that optimize outcome, but diagnosis can be challenging in this population. We present a case of postpartum he...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9742-9
更新日期：2012-12-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9104-9
更新日期：2008-01-01 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：BACKGROUND:Plateau waves are common in traumatic brain injury. They constitute abrupt increases of intracranial pressure (ICP) above 40 mmHg associated with a decrease in cerebral perfusion pressure (CPP). The aim of this study was to describe plateau waves characteristics with multimodal brain monitoring in head injur...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9918-y
更新日期：2014-08-01 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:Impaired cerebrovascular reactivity (CR) has been reported to be associated with adverse outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, CR may be determined using different paradigms and it is unclear, which measurement method most suitable reflects the clinical course or is abl...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-009-9287-8
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:Prompt management of aneurysmal subarachnoid hemorrhage (SAH) is critical. Literature is inconclusive regarding outcomes for patients directly admitted to specialized centers versus transferred from lower-volume hospitals. Providers are often unclear about the safety of transferring critical patients. This...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9740-y
更新日期：2012-12-01 00:00:00
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0040-x
更新日期：2007-01-01 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:Fever is common and difficult to control in patients with subarachnoid hemorrhage (SAH). We have previously shown an inverse relationship between fever and outcome in patients with SAH. MATERIALS/METHODS:This was a prospective, single-arm, feasibility trial in which nine patients with SAH underwent temper...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1385/NCC:1:2:145
更新日期：2004-01-01 00:00:00
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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
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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
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pub_type： 杂志文章,评审
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更新日期：2005-01-01 00:00:00
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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
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9867-5
更新日期：2013-10-01 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: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：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：: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: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:Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N(2)O) an...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-010-9363-0
更新日期：2010-08-01 00:00:00
