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 of intravenous (IV) bags used for compounding a vast amount of medications. Amino acid preparations, essential for compounding parenteral nutrition, were also directly impacted by the hurricane. Upon realization of the impending drug shortages, hospitals resorted to alternative methods of drug administration, such as IV push routes, formulary substitutions, or alternative drug therapies in hopes of preserving the small supply of IV bags available and prioritizing them for them most critical needs. In some cases, alternative drug therapies were required, which increased the risk of medication errors due to the use of less-familiar treatment options. Clinical pharmacists rounding with medical teams provided essential, patient-specific drug regimen alternatives to help preserve a dwindling supply while ensuring use in the most critical cases. Drug shortages also frequently occur in the setting of manufacturing delays or discontinuation and drug recalls, with potential to negatively impact patient care. The seriousness of the drug shortage crisis reached public attention by December 2017, when political and pharmacy organizations called for response to the national drug shortage crisis. In this article, we review institutional mitigation strategies in response to drug shortages and discuss downstream effects of these shortages, focusing on medications commonly prescribed in neurocritical care patients.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Clark SL,Levasseur-Franklin K,Pajoumand M,Barra M,Armahizer M,Patel DV,Wyatt Chester K,Tully APdoi
10.1007/s12028-019-00730-7subject
Has Abstractpub_date
2020-02-01 00:00:00pages
226-237issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-019-00730-7journal_volume
32pub_type
杂志文章,评审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：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：: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:The most widely used and most studied coma score to date is the Glasgow Coma Scale (GCS), which is used worldwide to assess level of consciousness and predict outcome after traumatic brain injury (TBI). Our aim was to determine whether the Full Outline of UnResponsiveness (FOUR) score is an accurate predicto...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9617-5
更新日期：2012-02-01 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：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:Recombinant activated Factor VII (rFVIIa) has recently gained popularity for rapid reversal of coagulopathy during operative neurosurgery. Patients undergoing chronic subdural hematoma (CSDH) or epidural hematoma (EDH) evacuation often have their coagulation status judged by preoperative international normal...
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：:Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-013-9872-8
更新日期：2014-02-01 00:00:00
abstract：BACKGROUND:During late pregnancy and the puerperium cerebral venous and sinus thrombosis (CVST) is a rare but important cause of stroke. Despite adequate anticoagulation some patients deteriorate, which may warrant the use of more aggressive treatment modalities. CASE REPORT:A 29-year-old pregnant woman (29th week of ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9389-3
更新日期：2011-08-01 00:00:00
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journal_title：Neurocritical care
pub_type： 历史文章,杂志文章
doi：10.1007/s12028-017-0495-3
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND/OBJECTIVES:To propose a novel definition for hydrocephalus growth and to further describe the association between hydrocephalus growth and poor outcome among patients with intracerebral hemorrhage (ICH). METHODS:We analyzed consecutive patients who presented within 6 h after ICH ictus between July 2011 and ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-020-01140-w
更新日期：2020-11-10 00:00:00
abstract：BACKGROUND:Median nerve short-latency somatosensory evoked potentials (SSEPs) are useful in determining prognosis for awakening after coma following hypoxic ischemic encephalopathy, but reliability of interpretation is unclear. OBJECTIVE:To measure inter- and intra-observer reliability of determining presence or absen...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9251-7
更新日期：2009-12-01 00:00:00
abstract：BACKGROUND:Hematoma expansion (HE) occurs in approximately one-third of patients with intracerebral hemorrhage (ICH) and is known to be a strong predictor of neurological deterioration as well as poor functional outcome. This study aims to externally validate three risk prediction models of HE (PREDICT, 9-point, and BR...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0631-8
更新日期：2019-04-01 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
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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：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:There is no uniform definition for cerebral microdialysis (CMD) probe location with respect to focal brain lesions, and the impact of CMD-probe location on measured molecule concentrations is unclear. METHODS:We retrospectively analyzed data of 51 consecutive subarachnoid hemorrhage patients with CMD-monito...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00713-8
更新日期：2020-02-01 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: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
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journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-020-01053-8
更新日期：2020-07-21 00:00:00
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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
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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
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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
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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
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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：: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: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：:In this article, we review technologies available for direct monitoring of cerebral oxygenation and metabolic status, including jugular venous oxygen saturation, brain tissue oxygen tension, transcranial cerebral oximetry with near-infrared spectroscopy, Positron emission tomography oxidative metabolism, single-photon...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1385/ncc:4:1:083
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND:Pooled European trial results of early decompressive craniectomy (DC) for severe hemispheric stroke did not require radiographic mass effect as an inclusion criterion. Early surgery for supratentorial cerebral hemorrhage does not improve functional status or survival compared to initial conservative medical ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0270-x
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:To describe a case of auto-immune encephalitis in an adolescent with favorable outcome despite prolonged status epilepticus. METHODS:A 17 year old Asian man without previous medical history developed alteration of consciousness and partial seizures. The diagnosis of anti-N-methyl-D-aspartate receptor enceph...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9788-8
更新日期：2013-02-01 00:00:00
