From intracranial pressure to intracranial pressure wave-guided intensive care management of a patient with an aneurysmal subarachnoid haemorrhage

2007 ◽  
Vol 51 (4) ◽  
pp. 501-504 ◽  
Author(s):  
P. K. Eide ◽  
W. Sorteberg ◽  
T. Meling ◽  
E. Jörum ◽  
J. Hald ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intracranial Pressure ◽  
Subarachnoid Haemorrhage ◽  
Pressure Wave ◽  
Care Management ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Intensive Care Management

scholarly journals Intravenous Nimodipine in Initial Intensive Care Management of Vasospasm in Aneurysmal Subarachnoid Haemorrhage – A Review

2021 ◽  
Author(s):  
Sreehari N R ◽  
Aadharsa Sugunan ◽  
Sheen Reynold ◽  
Athulya Subhash ◽  
Athul Gopan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care ◽  
Subarachnoid Haemorrhage ◽  
Care Management ◽  
T Test ◽  
Post Treatment ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Intensive Care Management ◽  
The Difference

Abstract Background: As known to every Neuroscientist the spontaneous subarachnoid haemorrhage is a medical condition in which bleeding occurs in subarachnoid space due to cerebrovascular disease most commonly due ruptured aneurysms. Nimodipine is a calcium channel antagonist used to treat vasospasm. When compared to oral, intravenous nimodipine shows better neurological outcome with low dose, less frequency of administration and less fluctuations of blood pressure in between doses ( as in oral ) due to availability of continuous infusion . Titrated dose Intra venous nimodipine is useful in the initial Intensive Care management of Subarachnoid haemorrhage for Vasospasm with close monitoring of blood pressure.Objective: To evaluate the clinical outcomes of intravenous Nimodipine in the management of acute ischemic vasospasm in subarachnoid hemorrhagic patients. Material and methods: The study was a prospective and observational study conducted in all inpatients with SAH having acute ischemic vasospasm in the intensive care unit using IV Nimodipine admitted the department of Neurosurgery in AIMS during a period of 1yr.Results: Evaluation of SAH occurrence in study patients (n=38) showed predominance of females (68.4%) and majority with hypertension (57.9%) as the common comorbid condition. The chance of developing SAH was high in patients who did not practice any form of exercise (60.5%). None of the patients had occurrence of adverse drug reactions while administering IV nimodipine other than hypotension which was corrected with inotropic support with close blood pressure monitoring. Out of the subjects enrolled, 37 patients showed improvement clinically and resolution of ischemic changes in CT scan . Majority of patients experienced cerebral edema. Using pair t test, it was found that the difference between the Glasgow Coma Score pre and follow up post treatment score were mild. Using pair t test, it was found that the difference between the mRS pre and follow up post treatment score were significant.Conclusion: Introduction of IV Nimodipine to the treatment strategy of SAH showed significant improvement in the clinical and radiological outcome.IV Nimodipine showed benefit in treating the condition without any life-threatening adverse events other than correctable hypotension. A significant decrease in the mRS score in majority of patients after treatment indicates the improvement in the quality of life of SAH patients. Pre and Post neurological status strengthens the evidence of improvement in our study subjects.

scholarly journals Intensive Care Management of Subarachnoid Haemorrhage

2013 ◽  
Vol 14 (1) ◽  
pp. 28-35 ◽  
Author(s):  
David Highton ◽  
Martin Smith
Keyword(s):  
Intensive Care ◽  
Subarachnoid Haemorrhage ◽  
Care Management ◽  
Neuronal Damage ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Intensive Care Management ◽  
Current Trends ◽  
Management Of Complications ◽  
Recent Developments ◽  
Consensus Guidance

Aneurysmal subarachnoid haemorrhage (SAH) is a devastating disease associated with high mortality and poor outcome in many survivors. Aggressive treatment by a comprehensive multidisciplinary team is associated with improved outcome, but the intensive care management of SAH presents significant challenges. Multimodal neuromonitoring may detect secondary insults before irreversible neuronal damage has occurred, and is increasingly being used to guide treatment. This article reviews current trends in the intensive care management of SAH from aspects of initial resuscitation to recent developments in the prevention and management of complications, including delayed cerebral ischaemia. Evidence from clinical trials and recent consensus guidance is reviewed.

A Randomized and Blinded Single-Center Trial Comparing the Effect of Intracranial Pressure and Intracranial Pressure Wave Amplitude-Guided Intensive Care Management on Early Clinical State and 12-Month Outcome in Patients With Aneurysmal Subarachnoid Hemorrhage

Neurosurgery ◽  
2011 ◽  
Vol 69 (5) ◽  
pp. 1105-1115 ◽  
Author(s):  
Per Kristian Eide ◽  
Gunnar Bentsen ◽  
Angelika G. Sorteberg ◽  
Pål Bache Marthinsen ◽  
Audun Stubhaug ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intracranial Pressure ◽  
Care Management ◽  
Wave Amplitude ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Clinical State ◽  
Primary Efficacy Variable ◽  
Primary Efficacy ◽  
Single Center ◽  
Intensive Care Management

Abstract BACKGROUND In patients with aneurysmal subarachnoid hemorrhage (SAH), preliminary results indicate that the amplitude of the single intracranial pressure (ICP) wave is a better predictor of the early clinical state and 6-month outcome than the mean ICP. OBJECTIVE To perform a randomized and blinded single-center trial comparing the effect of mean ICP vs mean ICP wave amplitude (MWA)-guided intensive care management on early clinical state and outcome in patients with aneurysmal SAH. METHODS Patients were randomized to 2 different types of ICP management: maintenance of mean ICP less than 20 mm Hg and MWA less than 5 mm Hg. Early clinical state was assessed daily using the Glasgow Coma Scale. The primary efficacy variable was 12-month outcome in terms of the Rankin Stroke Score. RESULTS Ninety-seven patients were included in the study. There were no significant differences in treatment between the 2 groups apart from a larger volume of cerebrospinal fluid drained during week 1 in the MWA group. There was a tendency toward higher Glasgow Coma Scale scores in the MWA group during weeks 1 (P = .08) and 2 (P = .07). Outcome in terms of Rankin Stroke Score at 12 months was significantly better in the MWA group (P < .05). CONCLUSION This randomized and blinded trial disclosed a significant better primary efficacy variable (Rankin Stroke Score after 12 months) in the MWA patient group. We suggest that proactive intensive care management with MWA-tailored cerebrospinal fluid drainage during the first week improves aneurysmal SAH outcome.

scholarly journals Continuous intracranial pressure monitoring in severe traumatic brain injury in children

2019 ◽  
pp. 101-104
Author(s):  
St. M. Iencean ◽  
A. Tascu ◽  
C. A. Apetrei ◽  
C. Gheorghita ◽  
Tsz-Yan Milly Lo ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Severe Traumatic Brain Injury ◽  
Care Management ◽  
Pressure Monitoring ◽  
Intensive Care Management ◽  
Emergency Hospital ◽  
Clinical Emergency

We present the results of the Romanian team for the multi-center grant “Paediatric Brain Monitoring with Information Technology (KidsBrainIT). Using IT Innovations to Improve Childhood Traumatic Brain Injury Intensive Care Management, Outcome, and Patient Safety”, acronym KidsBrainIT. Children aged 2 to 16 years who require intensive care management after sustaining traumatic severe brain injury are included in this study in three neurosurgical hospital: "Prof. Dr. N. Oblu" Clinical Emergency Hospital Iasi, "Sf. Maria" Children Clinical Emergency Hospital Iasi and "Bagdasar-Arseni" Clinical Emergency Hospital Bucharest. Continuous real-time intracranial pressure monitoring became a "gold standard" in TBI intensive-care management and ICP-lowering therapy is recommended when ICP is elevated above 20 mmHg or more. Continuous ICP and mean arterial blood pressure (MAP) monitoring allow calculation of cerebral perfusion pressure (CPP) and to establish of an optimal CPP. This study aims to improve the treatments and the outcomes in severe traumatic brain injury in children.

Recommendations for Intensive Care Management in Small Animals Following Anaesthesia

1992 ◽  
Vol 05 (02) ◽  
pp. 66-70
Author(s):  
Karol Mathews ◽  
Doris Dyson
Keyword(s):  
Intensive Care ◽  
Care Management ◽  
Small Animal ◽  
Small Animals ◽  
Monitoring Equipment ◽  
Intensive Care Management ◽  
Good Communication

Intensive care management can be provided in a small animal facility by centralisation of emergency and monitoring equipment. Good communication between all personnel involved in the case ensures that staff are prepared for complications that could arise related to recovery from anaesthesia.

scholarly journals Drug Overdosage in Children

1974 ◽  
Vol 2 (4) ◽  
pp. 303-309 ◽  
Author(s):  
T. C. K. Brown ◽  
F. I. Bishop ◽  
G. C. Mullins
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Emergency Treatment ◽  
Care Management ◽  
Tricyclic Antidepressants ◽  
Conscious State ◽  
Circulatory Failure ◽  
Intensive Care Management ◽  
Drug Overdosage

The epidemiology and prevention of drug overdosage in children is discussed. The emergency treatment of acute drug overdosage is outlined together with aspects of the intensive care management in relation to conscious state, convulsions, respiratory failure, circulatory failure and arrhythmias with some emphasis on tricyclic antidepressants.

scholarly journals Intensive care management of stroke patients.

Stroke ◽  
1976 ◽  
Vol 7 (6) ◽  
pp. 573-577 ◽  
Author(s):  
J W Norris ◽  
V C Hachinski
Keyword(s):  
Intensive Care ◽  
Care Management ◽  
Stroke Patients ◽  
Intensive Care Management
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