Search results for " brain injury"

Neuro-ICU patient disposition

2018

This article revises the recent evidence on ICU admission criteria for acute neurological patients [traumatic brain injury (TBI) patients, postoperative neurosurgical procedures and stroke].The appropriate utilization of ICU beds is essential, but it is complex and a challenge to attain. To date there are no widely accepted international guidelines for managing these acute brain-injured patients (stroke, TBI, postneurosurgery) in the ICU. The criteria for ICU admission after neurological acute injury, high-dependency unit or a specialized neurosurgical ward vary from institution to institution depending on local structures and characteristics of the available resources. Better evidence to s…

European evidence-based recommendations for clinical assessment of upper limb in neurorehabilitation (CAULIN): data synthesis from systematic reviews…

2021

Abstract Background Technology-supported rehabilitation can help alleviate the increasing need for cost-effective rehabilitation of neurological conditions, but use in clinical practice remains limited. Agreement on a core set of reliable, valid and accessible outcome measures to assess rehabilitation outcomes is needed to generate strong evidence about effectiveness of rehabilitation approaches, including technologies. This paper collates and synthesizes a core set from multiple sources; combining existing evidence, clinical practice guidelines and expert consensus into European recommendations for Clinical Assessment of Upper Limb In Neurorehabilitation (CAULIN). Methods Data from systema…

Surgical Treatment for Traumatic Brain Injury: Is It Time for Reappraisal?

2015

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in the United States. It is estimated that each year, on average, TBIs associated with 1.1 million visits to the emergency department, 235,000 hospitalizations, and 50,000 deaths.

Tissue Oxygenation in Normal and Edematous Brain Cortex During Arterial Hypocapnia

1984

Since arterial hypocapnia causes a cerebral blood flow decrease, hypocapnic conditions are induced in patients with severe traumatic brain injury by controlled hyperventilation in order to reduce the intracranial pressure (Gordon, 1971). Beneficial effects on the clinical course of patients, however, can be observed only under conditions of moderate hypocapnia. As shown by animal experiments severe arterial hypocapnia results in insufficient oxygen supply conditions in brain tissue (Grote et al., 1981), which subsequently influences the brain metabolism (Granholm et al., 1969, 1971) and counteracts the influence of hypocapnia on cerebral blood flow regulation (Grote et al., 1981). The prese…

Hipertensión endocraneal asociada a la sedación con sevoflurano mediante el dispositivo AnaConDa®en un paciente con traumatismo craneoencefálico seve…

2013

Sedation in neurocritical patients remains a challenge as there is no drug that meets all the requirements. Since the appearance of the AnaConDa® device, and according to the latest recommendations, sevoflurane has become an alternative for patients with brain injury. The use of AnaConDa® produces an increase in the anatomical dead space that leads to a decrease in alveolar ventilation. If the decrease in the alveolar ventilation is not offset by an increase in minute volume, there will be an increase in PaCO2. We report the case of a patient with severe traumatic brain injury who suffered an increase in intracranial pressure as a result of increased PaCO2 after starting sedation with the A…

2013

Following traumatic brain injury (TBI) neuroinflammatory processes promote neuronal cell loss. Alpha-melanocyte-stimulating hormone (α-MSH) is a neuropeptide with immunomodulatory properties, which may offer neuroprotection. Due to short half-life and pigmentary side-effects of α-MSH, the C-terminal tripeptide α-MSH(11–13) may be an anti-inflammatory alternative. The present study investigated the mRNA concentrations of the precursor hormone proopiomelanocortin (POMC) and of melanocortin receptors 1 and 4 (MC1R/MC4R) in naive mice and 15 min, 6, 12, 24, and 48 h after controlled cortical impact (CCI). Regulation of POMC and MC4R expression did not change after trauma, while MC1R levels incr…

El encuadre de los temas de salud: cobertura en prensa escrita del daño cerebral adquirido

2014

En este trabajo analizamos el encuadre informativo del Daño cerebral adquirido (DCA) en noticias publicadas en El País, El Mundo y La Vanguardia entre 2010 y 2013. Partiendo de una búsqueda léxica, se seleccionaron los textos que tematizaban el DCA, bien como tema central o secundario, y se analizaron las distintas categorías de encuadre discursivo. Los resultados muestran la escasa presencia del DCA en la prensa generalista, frente a su incidencia en nuestra sociedad, y que esta presencia escasa se refiere sobre todo a aspectos secundarios (prevención, necesidades asistenciales, calidad de vida), con especial magnificación de los avances tecnológicos. This paper analyzes the framing of Acq…

Erythropoietin in Traumatic Brain Injury: An Answer Will Come Soon

2015

Traumatic brain injury (TBI) is a major cause of morbidity and mortality in the United States. It is estimated that each year TBIs are associated with 1.1 million emergency department visits, 235,000 hospitalizations, and 50,000 deaths (1). Despite improvements in medical interventions, there are still no neuroprotective agents available to counteract secondary or delayed damage to the traumatically injured human brain or to promote its repair. TBI encompasses heterogeneous etiologic, anatomical, and molecular patterns of injury that exhibit different propensities to cause cerebral damage. Without careful consideration of individual injuries, the results of therapeutic trials remain difficu…

The management of unanticipated difficult airways in children of all age groups in anaesthetic practice - the position paper of an expert panel

2019

Abstract Children form a specific group of patients, as there are significant differences between children and adults in both anatomy and physiology. Difficult airway may be unanticipated or anticipated. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient’s death. There are few paediatric difficult-airway guidelines available in the current literature, and some of these have significant limitations. This position paper, intended for unanticipated difficult airway, was elaborated by the panel of specialists representing the Polish Society of Anaesthesiology and Intensive Care as well as the Polish Neonatal S…

Potentially Detrimental Effects of Hyperosmolality in Patients Treated for Traumatic Brain Injury

2021

Hyperosmotic therapy is commonly used to treat intracranial hypertension in traumatic brain injury patients. Unfortunately, hyperosmolality also affects other organs. An increase in plasma osmolality may impair kidney, cardiac, and immune function, and increase blood–brain barrier permeability. These effects are related not only to the type of hyperosmotic agents, but also to the level of hyperosmolality. The commonly recommended osmolality of 320 mOsm/kg H2O seems to be the maximum level, although an increase in plasma osmolality above 310 mOsm/kg H2O may already induce cardiac and immune system disorders. The present review focuses on the adverse effects of hyperosmolality on the function…