Neurocritical care
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Release of cardiac biomarkers is reported in patients with subarachnoid hemorrhage (SAH). Data addressing the impact of cardiac injury on outcome in these patients is sparse. This study was conducted to ascertain the association of elevation of serum cardiac Troponin-I (cTnI) with mortality and neurological outcome in patients with SAH. ⋯ Patients with subarachnoid hemorrhage and elevated cTnI are found to have worse neurological status at admission. These patients have a worse neurological outcome and in-hospital mortality.
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Comparative Study
One-minute dynamic cerebral autoregulation in severe head injury patients and its comparison with static autoregulation. A transcranial Doppler study.
To compare dynamic and static responses of cerebral blood flow to sudden or slow changes in arterial pressure in severe traumatic brain injury (TBI) patients. ⋯ A sharp dynamic vasodilator response could not be sustained, and a slow or absent reaction to a sudden hypotensive challenge could show an acceptable cerebral autoregulation in the steady state. We found that patients with impaired static cerebral autoregulation had a poor outcome, whereas those with preserved static cerebral autoregulation experience favorable outcomes.
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To assess the impact of blood glucose, coagulopathy, seizures and prior statin and aspirin use on clinical outcome following intracerebral hemorrhage (ICH). ⋯ The significant association of prior statin use with decreased mortality warrants prospective evaluation of the use of statins following ICH.
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Comparative Study
A comparison of nicardipine and labetalol for acute hypertension management following stroke.
Evaluate the ease of use and tolerability of labetalol (L) and nicardipine (N) for hypertension management in patients with acute stroke. ⋯ Nicardipine offers an alternative to labetalol with similar tolerability and appears to provide a smoother blood pressure control compared to labetalol.
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The vast majority of patients with intracerebral hemorrhage (ICH) are admitted to an intensive care unit (ICU). Patients admitted to ICUs have a high risk of developing nosocomial infections, while complicating infection appears to be associated with a longer ICU stay. An increased length of ICU stay translates directly into increased costs. The aim of this study was to assess the impact of a complicating infection on the length of ICU stay in patients with ICH. ⋯ Complicating infection was an independent predictor of a prolonged ICU stay in patients with ICH.