Neurocritical Care

2017 ◽  
Author(s):  
Steven L. Shein ◽  
Robert S. B. Clark
Keyword(s):  
Brain Injury ◽  
Neurocritical Care ◽  
Pediatric Intensive Care ◽  
Brain Dysfunction ◽  
Neurological Injury ◽  
Proximate Cause ◽  
Anatomy And Physiology ◽  
Pediatric Neurocritical Care ◽  
Improve Patient

Brain injury is the most common proximate cause of death in pediatric intensive care units. For children who survive critical illness, long-standing brain damage and residual brain dysfunction can affect quality of life significantly. Therefore, minimizing neurological injury to improve patient outcomes is a priority of neurocritical care. This may be accomplished by implementing specific targeted therapies, avoiding pathophysiological conditions that exacerbate neurological injury, and using a multidisciplinary team that focuses on contemporary care of children with neurological injury and disease. This chapter reviews pertinent anatomy and physiology; general principles of pediatric neurocritical care; and specifics for caring for children with traumatic brain injury, hypoxic–ischemic encephalopathy, status epilepticus, meningitis/encephalitis, stroke, and acute hydrocephalus.

Multimodality Monitoring in Neurocritical Care: Decision-Making Utilizing Direct And Indirect Surrogate Markers

2018 ◽  
Vol 34 (6) ◽  
pp. 449-463 ◽  
Author(s):  
Fawaz Al-Mufti ◽  
Megan Lander ◽  
Brendan Smith ◽  
Nicholas A. Morris ◽  
Rolla Nuoman ◽  
...  
Keyword(s):  
Brain Injury ◽  
Neurocritical Care ◽  
Delayed Cerebral Ischemia ◽  
Neurological Injury ◽  
Innovative Technology ◽  
Secondary Brain Injury ◽  
Neurologic Injury ◽  
Irreversible Damage ◽  
Traumatic Intracranial Hemorrhage ◽  
Substantial Progress

Substantial progress has been made to create innovative technology that can monitor the different physiological characteristics that precede the onset of secondary brain injury, with the ultimate goal of intervening prior to the onset of irreversible neurological damage. One of the goals of neurocritical care is to recognize and preemptively manage secondary neurological injury by analyzing physiologic markers of ischemia and brain injury prior to the development of irreversible damage. This is helpful in a multitude of neurological conditions, whereby secondary neurological injury could present including but not limited to traumatic intracranial hemorrhage and, specifically, subarachnoid hemorrhage, which has the potential of progressing to delayed cerebral ischemia and monitoring postneurosurgical interventions. In this study, we examine the utilization of direct and indirect surrogate physiologic markers of ongoing neurologic injury, including intracranial pressure, cerebral blood flow, and brain metabolism.

scholarly journals Sleep Measure Validation in a Pediatric Neurocritical Care Acquired Brain Injury Population

2019 ◽  
Vol 33 (1) ◽  
pp. 196-206 ◽  
Author(s):  
Katrina M. Poppert Cordts ◽  
Trevor A. Hall ◽  
Mary E. Hartman ◽  
Madison Luther ◽  
Amanda Wagner ◽  
...  
Keyword(s):  
Brain Injury ◽  
Neurocritical Care ◽  
Acquired Brain Injury ◽  
Measure Validation ◽  
Pediatric Neurocritical Care

Child health-related quality of life following neurocritical care for traumatic brain injury: an analysis of preference-weighted outcomes

2007 ◽  
Vol 7 (1) ◽  
pp. 64-75 ◽  
Author(s):  
John M. Tilford ◽  
Mary E. Aitken ◽  
Allen C. Goodman ◽  
Debra H. Fiser ◽  
Jeffrey B. Killingsworth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Child Health ◽  
Neurocritical Care ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals A-064 Executive Functioning in an Acute Pediatric Neurocritical Care Population Recently Discharged from the PICU: Exploring the Associations among Parent Report and Individual Performance Measures

2020 ◽  
Vol 35 (6) ◽  
pp. 854-854
Author(s):  
Holding E ◽  
Bradbury K ◽  
Leonard S ◽  
Turner E ◽  
Williams C ◽  
...  
Keyword(s):  
Critical Care ◽  
Brain Injury ◽  
Executive Functioning ◽  
Neurocritical Care ◽  
Recovery Phase ◽  
Individual Performance ◽  
Parent Report ◽  
Post Discharge ◽  
And Performance ◽  
Pediatric Neurocritical Care

Abstract Objective An emerging literature has identified that PICU survivors face a host of long-term physical, cognitive, emotional, and psychosocial difficulties that stem from the underlying concern and side effects of critical care intervention. Research shows that executive functioning (EF) is particularly vulnerable to sequelae. This study sought to understand associations between parent-report of daily life EF and performance-based measures following neurocritical care. Method Twenty-three children ages 8–16 (M = 12.66 years; 39% male) were screened as part of an integrated (neuropsychology and pediatric critical care) acute phase (3–6-week post-discharge) follow-up clinic. Injuries included children with traumatic brain injury (n = 19), or acquired brain injury (i.e., anoxic brain injury, AVM, acute cerebellitis, hemorrhagic stroke; n = 4). EF outcomes were assessed using the Behavior Rating Inventory of Executive Functioning, Second Edition (BRIEF-2), Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test and Verbal Fluency Test, Children’s Memory Scale Digits Backwards, and Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) Coding and Symbol Search subtests. Bivariate correlations were used to examine associations among parent-report of EF and performance-based measures of EF in our neurocritical care population. Results Analyses demonstrated significant (□ = .05) correlations between the WISC-V Coding subtest and the BRIEF-2 Shift scale (r = −.44) and Global Executive Composite (GEC; r = −.59). Correlations between D-KEFS Category Fluency and BRIEF-2 Initiate (r = −.51), Working Memory (r = −.44), and GEC (r = −.55) were significant. Inverse correlations demonstrate agreement. Conclusion In the acute recovery phase following neurocritical care, parent-report and specific performance-based measures are only moderately associated, demonstrating the importance of multi-method assessment to detect potential acquired deficits to inform rehabilitation.

scholarly journals Automated Infrared Pupillometer Use in Assessing the Neurological Status in Pediatric Neurocritical Care Patients: Case Reports and Literature Review

2021 ◽  
Vol 11 (01) ◽  
pp. e125-e132
Author(s):  
Molly E. McGetrick ◽  
Nathan Schneider ◽  
DaiWai M. Olson ◽  
Venkatesh Aiyagari ◽  
Darryl Miles
Keyword(s):  
Neurocritical Care ◽  
Case Reports ◽  
Clinical Status ◽  
Pediatric Intensive Care ◽  
Standard Of Care ◽  
Neurological Status ◽  
Pupillary Light ◽  
Infrared Pupillometry ◽  
Pediatric Neurocritical Care ◽  
Neurological Pupil Index

AbstractAutomated infrared pupillometry (AIP) is rapidly becoming an accepted standard for the evaluation of pupil size and reactivity in adult neurocritical care. Recently, pediatric centers are increasingly utilizing this technology, but data supporting its use in children are limited. Our pediatric intensive care unit instituted AIP as a standard of care for pupillary light assessments in neurocritical care patients in early 2020. In this article, we describe four cases highlighting the advantage of using objective assessments of the pupillary light reactivity response measured by the Neurological Pupil index (NPi) to detect early changes in the patient's neurological status. These cases support the applicability of AIP in pediatric neurocritical care as a noninvasive neurologic monitoring tool. The NPi may be superior to manual pupil assessments by providing a numerical scale for accurate trending clinical status of a patient's neurologic condition.

scholarly journals Utility of the Color-Coded Duplex Neurosonographic Spectrum in Critically Ill Children in Resource-Limited Centers: A Case Series

2021 ◽  
Author(s):  
Patrick Caqui-Vilca ◽  
Jesús Dominguez-Rojas ◽  
Javier Ponce ◽  
Gabriel Omar Heredia-Orbegoso
Keyword(s):  
Intensive Care ◽  
Diagnostic Method ◽  
Neurocritical Care ◽  
Case Series ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Resource Limited ◽  
Therapeutic Measures ◽  
Flow Changes ◽  
Pediatric Neurocritical Care

Abstract Ultrasound in pediatric neurocritical care has a wide variety of indications, such as the study of vasospasm in subarachnoid hemorrhage, flow changes in intracranial stenosis, endocranial hypertension and to evaluate some therapeutic measures. The following is a series of five most relevant cases collected from Pediatric Intensive Care with abnormal images in transcranial duplex (TCD) and their typical findings in this type of studies. Transcranial duplex offers a diagnostic method of rapid evaluation that provides reliable information for decision making in pediatric intensive care, but it is a tool with which there is little experience in the country, so these findings are didactic and should be complemented with studies of greater diagnostic relevance.

Acquired Brain Injury Quality of Life Scale

2019 ◽  
Author(s):  
María Fernández ◽  
Laura E. Gómez ◽  
Víctor B. Arias ◽  
Virginia Aguayo ◽  
Antonio M. Amor ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Injury ◽  
Acquired Brain Injury ◽  
Quality Of Life Scale ◽  
Life Scale

Decompressive Craniectomy is Associated with Improved Quality of Life Up to Ten Years After Rehabilitation from Traumatic Brain Injury

2019 ◽  
Author(s):  
Katrin Rauen ◽  
Lara Reichelt ◽  
Philipp Probst ◽  
Barbara Schäpers ◽  
Friedemann Müller ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy
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