Search results for "GLASGOW COMA SCALE"

Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observat…

2021

Background: The indications for intracranial pressure (ICP) monitoring in patients with acute brain injury and the effects of ICP on patients’ outcomes are uncertain. The aims of this study were to describe current ICP monitoring practises for patients with acute brain injury at centres around the world and to assess variations in indications for ICP monitoring and interventions, and their association with long-term patient outcomes. Methods: We did a prospective, observational cohort study at 146 intensive care units (ICUs) in 42 countries. We assessed for eligibility all patients aged 18 years or older who were admitted to the ICU with either acute brain injury due to primary haemorrhagic…

Testing physiologic monitor alarm customization software to reduce alarm rates and improve nurses’ experience of alarms in a medical intensive care u…

2018

BACKGROUND:Clinicians in intensive care units experience alarm fatigue related to frequent false and non-actionable alarms produced by physiologic monitors. To reduce non-actionable alarms, alarm settings may need to be customized for individual patients; however, nurses may not customize alarms because of competing demands and alarm fatigue. OBJECTIVE:To examine the effectiveness and acceptance of physiologic monitor software to support customization of alarms. METHODS:This pre/post intervention study was conducted in a 56-bed medical intensive care unit. IntelliVue® Alarm Advisor customization support software for alarm limit violations was installed on all monitors and education on its u…

Results of targeted temperature management of patients after sudden out‐of‐hospital cardiac arrest: a comparison between intensive general and cardia…

2019

ABSTRACT Background: Targeted temperature management (TTM) is used to treat patients after sudden out‑of‑hospital cardiac arrest (OHCA). Aims: The aim of the study was to compare the results of TTM between intensive general and cardiac care units (ICCUs). Methods: The Polish Registry of Therapeutic Hypothermia obtained data on 377 patients with OHCA from 26 centers (257 and 120 patients treated at the ICCU and intensive care unit [ICU], respectively). Eligibility for TTM was based on the current inclusion criteria for therapy. Medical history as well as data on TTM and additional treatment were analyzed. The main outcomes included in‑hospital survival and complications as well as neurologic…

Minimally Invasive Management of Spontaneous Supratentorial Intracerebral Lobar Hemorrhages by a “Homemade” Endoscopic Strategy: The Evangelical Doct…

2019

Background Although the incidence of intracerebral hemorrhage (ICH) has appeared to be increasing over the years, its prognosis remains dismal. No consensus has yet been reached regarding the management of ICH; however, minimally invasive surgery should limit, if not avoid, intraoperative parenchymal damage. Therefore, we have presented a novel, modified “homemade” approach aimed to shorten the operative time and minimize the corticectomy and brain manipulation. Methods From 2008 to 2017, 53 patients (32 men and 21 women; mean age, 63.8 years) were admitted to our neurosurgery department and surgically treated for a lobar ICH. A modified suction tube, coupled with the endoscope light source…

Hypertonic saline solution and decompressive craniectomy for treatment of intracranial hypertension in pediatric severe traumatic brain injury.

2002

Experimental data 8 –11 and first clinical results in adults 12,13 suggest that hypertonic saline ( 1.0) may be highly effective in lowering ICP even when mannitol has lost its therapeutic potential after prolonged and repeated use. In children, only limited experience exists with the use of hypertonic saline solutions: a randomized prospective study in children with severe head injury compared the effects on ICP (increased to 15–20 mm Hg) of isotonic (0.9% NaCl) and hypertonic (3% NaCl) saline injections, demonstrating a beneficial effect of the hypertonic solution. 14 Another prospective randomized trial compared the effects of continuous infusion of either lactated Ringer’s solution (277…

The relation between the incidence of hypernatremia and mortality in patients with severe traumatic brain injury

2009

Introduction The study was aimed at verifying whether the occurrence of hypernatremia during the intensive care unit (ICU) stay increases the risk of death in patients with severe traumatic brain injury (TBI). We performed a retrospective study on a prospectively collected database including all patients consecutively admitted over a 3-year period with a diagnosis of TBI (post-resuscitation Glasgow Coma Score ≤ 8) to a general/neurotrauma ICU of a university hospital, providing critical care services in a catchment area of about 1,200,000 inhabitants. Methods Demographic, clinical, and ICU laboratory data were prospectively collected; serum sodium was assessed an average of three times per …

Extubation strategies in neuro-intensive care unit patients and associations with outcomes

2020

Background Prolonged invasive ventilation is common in patients with severe brain injury. Information on optimal management of extubation and on the use of tracheostomy in these patients is scarce. International guidelines regarding the ventilator liberation and tracheostomy are currently lacking. Methods The aim of 'Extubation strategies in Neuro-Intensive care unit patients and associations with Outcomes' (ENIO) study is to describe current management of weaning from invasive ventilation, focusing on decisions on timing of tracheal extubation and tracheostomy in intensive care unit (ICU) patients with brain injury. We conducted a prospective, international, multi-centre observational stud…

Low risk of intracranial emergency in patients with minor head injury treated with antiplatelet therapy.

2021

A PCA Interpretation of the Glasgow Coma Scale in the Trauma Brain Injury PECARN Dataset

2018

CT scan is strongly recommended for a patient affected by head trauma, but he/she must absorb a certain amount of radiations. For this reason, the physician tries to avoid such a practice for pediatric patients. The symptoms analysis, visual/tactile inspection, and reactions to appropriate stimuli from the physician could induce him/her to put the patient in a period of observation instead of performing an immediate CT scan. As a consequence, the correct evaluation of those symptoms is a crucial task. For this reason, the Pediatric Glasgow Coma Scale (PGCS) plays a fundamental role, because it is a numeric scale regarding the patient’s mental status. It is computed as the sum of the score f…

COVID-19 and the impact on the cranio-oro-facial trauma care in Italy:An epidemiological retrospective cohort study

2021

The coronavirus disease 2019 (COVID-19) has deeply modified the organization of hospitals, health care centers, and the patient’s behavior. The aim of this epidemiological retrospective cohort study is to evaluate if and how the COVID-19 pandemic has determined a modification in cranio-oro-facial traumatology service. Methods: The dataset included hospital emergency room access of a six-month pre-pandemic period and six months into pandemic outbreak. The variables collected were: patient age, gender, type of emergency access with relative color code, Glasgow Coma Scale Score, type of discharge. Results: 537 vs. 237 (pre-pandemic vs. pandemic) patients accessed the hospital emergency room an…