scholarly journals The Incidence of Hyperthermia during Craniotomy

2018 ◽  
Vol 46 (4) ◽  
pp. 368-373
Author(s):  
G. Malpas ◽  
J. A. Taylor ◽  
D. Cumin ◽  
A. F. Merry ◽  
S. J. Mitchell
Keyword(s):  
Brain Injury ◽  
Standard Deviation ◽  
Observational Study ◽  
Demographic Data ◽  
Anaesthetic Management ◽  
Temperature Data ◽  
Compelling Evidence ◽  
Mild Hyperthermia ◽  
Potential Harm ◽  
Temperature Reading

There is evidence that even mild hyperthermia may exacerbate brain injury. There seem reasonable grounds for considering patients undergoing craniotomy as ‘at risk’ for brain injury. A retrospective observational study was undertaken to measure the incidence of mild hyperthermia in craniotomy cases in which the patient was initially normothermic. Auckland City Hospital's database of electronic anaesthetic records was searched for adult patients who were normothermic (≤37°C) prior to undergoing craniotomy procedures. For each case, demographic data, intraoperative naso- or oropharyngeal temperature measurements, and paracetamol use were extracted. We identified the proportion of patients whose temperature rose to exceed normal (>37°C) and further subdivided that group into the proportion in whom the temperature rose to ≥38°C. Two thousand, nine hundred and thirty-five craniotomy cases began their operations while normothermic and had adequate temperature data collected. There were 984 (33.5%) cases that had at least one temperature reading >37°C, for a mean (standard deviation [SD]) time of 66.0 (64.6) minutes, and 49 (1.7%) cases that had at least one reading ≥38°C for a mean (SD) time of 40.4 (38.1) minutes. The majority (77.8%) who became mildly hyperthermic remained so at the end of the procedure. New mild hyperthermia occurs commonly during craniotomy. In view of the compelling evidence of potential harm arising from mild hyperthermia in brain injury, these findings suggest an opportunity for practice improvement in the anaesthetic management of craniotomy patients. Reasonable steps should be taken by anaesthetists to avoid intraoperative hyperthermia of any degree.

Clinical course of SARS-CoV-2 infection in patients with severe acquired brain injury and a disorder of consciousness: an observational study

Brain Injury ◽  
2021 ◽  
Vol 35 (5) ◽  
pp. 520-529
Author(s):  
Antonio Caronni ◽  
Emanuele Liaci ◽  
Anna Bianchi ◽  
Alessandro Viganò ◽  
Francesco Marenco ◽  
...  
Keyword(s):  
Brain Injury ◽  
Observational Study ◽  
Clinical Course ◽  
Acquired Brain Injury ◽  
Disorder Of Consciousness ◽  
Severe Acquired Brain Injury

Rotterdam and Marshall Scores for Prediction of in-hospital Mortality in Patients with Traumatic Brain Injury: An observational study

Brain Injury ◽  
2021 ◽  
pp. 1-9
Author(s):  
Mohammad Asim ◽  
Ayman El-Menyar ◽  
Ashok Parchani ◽  
Syed Nabir ◽  
Mohamed Nadeem Ahmed ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Observational Study ◽  
Hospital Mortality

scholarly journals Comparison of motor outcomes between preschool children with univentricular and biventricular critical heart disease not diagnosed with cerebral palsy or acquired brain injury

2021 ◽  
pp. 1-8
Author(s):  
M. Florencia Ricci ◽  
Alastair Fung ◽  
Diane Moddemann ◽  
Victoria Micek ◽  
Gwen Y. Bond ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Heart Disease ◽  
Preschool Children ◽  
Brain Injury ◽  
Standard Deviation ◽  
Motor Skills ◽  
Odds Ratio ◽  
Motor Impairment ◽  
Acquired Brain Injury ◽  
Manual Dexterity

Abstract This comparison study of two groups within an inception cohort aimed to compare the frequency of motor impairment between preschool children with univentricular and biventricular critical congenital heart disease (CHD) not diagnosed with cerebral palsy/acquired brain injury, describe and compare their motor profiles and explore predictors of motor impairment in each group. Children with an intellectual quotient <70 or cerebral palsy/acquired brain injury were excluded. Motor skills were assessed with the Movement Assessment Battery for Children-2. Total scores <5th percentile indicated motor impairment. Statistical analysis included χ2 test and multiple logistic regression analysis. At a mean age of 55.4 (standard deviation 3.77) months, motor impairment was present in 11.8% of those with biventricular critical CHD, and 32.4% (p < 0.001) of those with univentricular critical CHD. The greatest difference between children with biventricular and univentricular CHD was seen in total test scores 8.73(2.9) versus 6.44(2.8) (p < 0.01) and in balance skills, 8.84 (2.8) versus 6.97 (2.5) (p = 0.001). Manual dexterity mean scores of children with univentricular CHD were significantly below the general population mean (>than one standard deviation). Independent odds ratio for motor impairment in children with biventricular critical CHD was presence of chromosomal abnormality, odds ratio 10.9 (CI 2.13–55.8) (p = 0.004); and in children with univentricular critical CHD odds ratio were: postoperative day 1–5 highest lactate (mmol/L), OR: 1.65 (C1.04–2.62) (p = 0.034), and dialysis requirement any time before the 4.5-year-old assessment, OR: 7.8 (CI 1.08–56.5) (p = 0.042). Early assessment of motor skills, particularly balance and manual dexterity, allows for intervention and supports that can address challenges during the school years.

Semi-quantitative Cough Strength Score as a Predictor for Extubation Outcome in Traumatic Brain Injury: A Prospective Observational Study

2018 ◽  
Vol 29 (2) ◽  
pp. 273-279
Author(s):  
Abdelrady S. Ibrahim ◽  
Mohamed G. Aly ◽  
Khaled A. Abdel-Rahman ◽  
Mona A. Mohamed ◽  
Mogedda M. Mehany ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Extubation Outcome ◽  
Cough Strength

Do methods of hospital pre-alerts influence the on-scene times for acute pre-hospital stroke patients? A retrospective observational study

2021 ◽  
Vol 6 (2) ◽  
pp. 19-25
Author(s):  
Jacob Gunn
Keyword(s):  
Standard Deviation ◽  
Observational Study ◽  
Acute Stroke ◽  
Ambulance Service ◽  
Time Saving ◽  
North East ◽  
Admission Policies ◽  
The Mean ◽  
Time Critical ◽  
Mean Time

Introduction: Stroke is one of the leading causes of death and disability worldwide. The ambulance service is often the first medical service to reach an acute stroke patient, and due to the time-critical nature of stroke, a time-critical assessment and rapid transport to a hyper acute stroke unit are essential. As stroke services have been centralised, different hospitals have implemented different pre-alert admission policies that may affect the on-scene time of the attending ambulance crew. The aim of this study is to investigate if the different pre-alert admission policies affect time on scene.Method: The current study is a retrospective quantitative observational study using data routinely collected by North East Ambulance Service NHS Foundation Trust. The time on scene was divided into two variables; group one was a telephone pre-alert in which a telephone discussion with the receiving hospital is required before they accept admission of the patient. Group two was a radio-style pre-alert in which the attending clinician makes an autonomous decision on the receiving hospital and alerts them via a short radio message of the incoming patient. These times were then compared to identify if there was any difference between them.Results: Data on 927 patients over a three-month period, from October to December 2019, who had received the full stroke bundle of care, were within the thrombolysis window and recorded as a stroke by the attending clinician, were split into the variable groups and reported on. The mean time on scene for a telephone call pre-alert was 33 minutes and 19 seconds, with a standard deviation of 13 minutes and 8 seconds. The mean on-scene time for a radio pre-alert was 28 minutes and 24 seconds, with a standard deviation of 11 minutes and 51 seconds.Conclusion: A pre-alert given via radio instead of via telephone is shown to have a mean time saving of 4 minutes and 55 seconds, representing an important decrease in time which could be beneficial to patients.

scholarly journals Traumatic Brain Injury, Aging and Reaction Time

1989 ◽  
Vol 16 (2) ◽  
pp. 161-167 ◽  
Author(s):  
D.T. Stuss ◽  
L.L. Stethem ◽  
T.W. Picton ◽  
E.E. Leech ◽  
G. Pelchat
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Standard Deviation ◽  
Reaction Time ◽  
Attentional Control ◽  
Focused Attention ◽  
Redundant Information ◽  
Complex Reaction ◽  
Control Processes ◽  
Simple Rt

ABSTRACT:The effects of traumatic brain injury (TBI) and aging were compared on tests of simple and complex reaction time (RT). Simple RT was not significantly affected by aging or TBI. TBI patients, however, tended to be slower on Simple RT tasks, and had a larger standard deviation. Individuals over age 60 and patients of any age with TBI demonstrated slower RT with choice RT tests. In addition, both groups (those over 60 and TBI patients) were less able than other groups to inhibit the processing of redundant information. For the TBI patients, this occurred primarily on reassessment. These results suggest that the deficit in both aging and TBI is not only a generalized neuronal slowing but a more specific impairment in attentional control processes, exhibited as a deficit in focused attention.

scholarly journals Routine veterinary anaesthetic management practices in South Africa

2000 ◽  
Vol 71 (3) ◽  
Author(s):  
K.E. Joubert
Keyword(s):  
South Africa ◽  
Mortality Rate ◽  
Continuing Education ◽  
Management Practices ◽  
Demographic Data ◽  
Anaesthetic Management ◽  
Practice Size ◽  
Induction Of Anaesthesia ◽  
Education Courses ◽  
Induction Agents

A survey of the routine anaesthetic management of dogs and cats during sterilisation by veterinarians in South Africa was conducted. This report describes the premedication, induction and maintenance agents most commonly used in dogs and cats. Information about monitoring of patients during the procedure and who is responsible for induction of anaesthesia and monitoring was obtained. Questionnaires were analysed with regard to demographic data, practice size, continuing education, the number of surgical procedures and sterilisations performed per week and an estimate of yearly mortality. Acetylpromazine is the most commonly used premedication in dogs and xylazine in cats. Thiopentone in dogs and alphaxalone/alphadolone in cats were the induction agents most commonly used. Alphaxalone/alphadolone in cats and halothane in dogs are the most commonly used maintenance agents. Records of anaesthesia are poorly kept and monitoring of patients is poorly performed. Respiratory rate is the parameter most commonly monitored (90.7 %), and in most cases is the sole parameter. On average 10.34 ± 8.25 cats were operated per week, of which 5.45 ±5.60 were sterilised; 17.79 ±11.61 dogs were operated per week, of which 8.65 ±7.10 were sterilised. In total, 190 patients died under anaesthesia, a mortality rate of 1:1243. Just over 50 % of practitioners had attended continuing education courses during their careers.

scholarly journals Anatomical Localization of Traumatic Brain Injury Cases in Eastern Macedonia and Thrace, Greece: a 10-year Retrospective Observational Study

2020 ◽  
Vol 16 ◽  
Author(s):  
Maria-Valeria Karakasi ◽  
Alexandrina S. Nikova ◽  
Christina Valsamidou ◽  
Pavlos Pavlidis ◽  
Theodossios A. Birbilis
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Observational Study ◽  
Retrospective Observational Study ◽  
Anatomical Localization
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