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 retrospectively analyzed a prospectively collected cohort of ICH patients ascertained between 1994 and 2015. We identified subjects with lymphocyte count obtained within 24 h from onset, and AL was defined as lymphocyte count <1000/μL. Infectious complications were assessed through retrospective chart review. Association between AL, infections, and mortality was investigated using multivariable logistic regression. RESULTS:Of the 2014 patients meeting inclusion criteria, 548 (27.2%) had AL and 605 (30.0%) developed an infectious complication. Case-fatality at 90 days was 36.9%. Patients with AL had larger hematoma volumes, higher frequency of intraventricular hemorrhage, and lower Glasgow Coma Scale score on presentation (all p < 0.001). AL was independently associated with increased risk of pneumonia [odds ratio (OR) 1.97, 95% confidence interval (CI) 1.50-2.58, p < 0.001] and multiple infections (OR 1.84, 95% CI 1.24-2.71, p = 0.003). AL was also an independent predictor of 90-day mortality (OR 1.55, 95% CI 1.18-2.04, p = 0.002) after adjusting for confounders. CONCLUSIONS:AL is common in ICH patients and independently associated with increased risk of infectious complications and poor outcome. Further studies will be needed to determine whether prophylactic antibiotics in ICH patients with AL can improve outcome.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Morotti A,Marini S,Jessel MJ,Schwab K,Kourkoulis C,Ayres AM,Gurol ME,Viswanathan A,Greenberg SM,Anderson CD,Goldstein JN,Rosand Jdoi
10.1007/s12028-016-0367-2subject
Has Abstractpub_date
2017-04-01 00:00:00pages
160-166issue
2eissn
1541-6933issn
1556-0961pii
10.1007/s12028-016-0367-2journal_volume
26pub_type
杂志文章abstract：BACKGROUND:The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simul...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0521-0
更新日期：2018-06-01 00:00:00
abstract：INTRODUCTION:Cerebral vasospasm in aneurysmal subarachnoid hemorrhage (SAH) is associated with poor outcome. The safety and feasibility of continuous high-dose intravenous magnesium sulfate (MgSO4) for the prevention of cerebral vasospasm and ischemic cerebral injury has not been well studied. METHODS:Patients present...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1385/NCC:3:1:016
更新日期：2005-01-01 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: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：: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：BACKGROUND:Spontaneous intracranial hypotension (SIH) is a neurologic condition with the prototypical symptom of orthostatic headache. We report a dramatic case of SIH with life-threatening bilateral hygroma and uncal herniation. METHODS:Case report. RESULTS:A 44-year-old male patient presenting with orthostatic head...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9783-0
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:Therapeutic hypothermia (i.e., temperature management) is an effective option for improving survival and neurological outcome after cardiac arrest and is potentially useful for the care of the critically ill neurological patient. We analyzed the feasibility of a device to control the temperature of the brain...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0257-7
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:The natural history of cerebral aneurysms derived from metastatic spread of cardiac myxomas is not well known, and their management presents many dilemmas. METHODS:Case report and literature review. RESULTS:An 18-year-old man presented with an intraparenchymal hemorrhage several months after resection of a...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9400-z
更新日期：2010-10-01 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: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：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: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：:This review examines the available data on the use of osmotic agents in patients with head injury and ischemic stroke, summarizes the physiological effects of osmotic agents, and presents the leading hypotheses regarding the mechanism by which they reduce ICP. Finally, it addresses the validity of the following common...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1385/NCC:1:2:219
更新日期：2004-01-01 00:00:00
abstract：:Sleep is fundamental for everyday functioning, yet it is often negatively impacted in critically ill patients by the intensive care setting. With a focus on the neurological intensive care unit (NeuroICU), this narrative review summarizes methods of measuring sleep and addresses common causes of sleep disturbance in t...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00795-4
更新日期：2020-04-01 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：:Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a uniq...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-016-0338-7
更新日期：2017-08-01 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：: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 effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with compute...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-017-0379-6
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND/OBJECTIVE:Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity, typically manifesting as reversible neurological symptoms and signs of white matter edema on magnetic resonance imaging. PRES has been widely described in adults. Studies of PRES in children are mostly limited ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00720-9
更新日期：2020-02-01 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: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: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：OBJECTIVE:Stroke due to occlusion of the artery of Percheron (AOP), an uncommon anatomic variant supplying the bilateral medial thalami, may raise diagnostic challenges and cause life-threatening symptoms. Our objective here was to detail the features and outcomes in three patients who required intensive care unit (ICU...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-014-9962-2
更新日期：2014-06-01 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: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 i...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9491-6
更新日期：2011-04-01 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：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...
journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-014-0030-8
更新日期：2015-02-01 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：INTRODUCTION:Methylene blue (MB) infusion is frequently used to localize the parathyroid glands during parathyroidectomy and generally considered safe. Several recent reports suggest neurological toxicity and post-operative altered mental state typically after large dose infusions. The mechanism by which MB has neuroto...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9206-z
更新日期：2009-01-01 00:00:00
