Neurocritical care
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Neurostimulants may improve or accelerate cognitive and functional recovery after intracerebral hemorrhage (ICH), ischemic stroke (IS), or subarachnoid hemorrhage (SAH), but few studies have described their safety and effectiveness in the intensive care unit (ICU). The objective of this study was to describe amantadine and modafinil administration practices during acute stroke care starting in the ICU and to evaluate safety and effectiveness. ⋯ Neurostimulant administration during acute stroke care may improve wakefulness. Future controlled studies with a neurostimulant administration protocol, prospective evaluation, and discretely defined response and safety criteria are needed to confirm these encouraging findings.
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Telemetric intracranial pressure (ICP) monitoring is a new method of measuring ICP which eliminates some of the shortcomings of previous methods. However, there are limited data on specific characteristics, including the advantages and disadvantages of this method. The main aim of this study was to demonstrate the indications, benefits, and complications of telemetric ICP monitoring. ⋯ The associated complication rate was 7.1%. Despite the increasing application of telemetric monitoring devices, studies to evaluate specific characteristics of this method have been infrequent and inadequate. Future research using a higher level of scientific methods is needed to evaluate advantage and disadvantages.
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Stereotactic minimally invasive surgery (sMIS) has been used in the treatment of intracerebral hemorrhage (ICH) in recent years and has obtained promising results. However, the outcomes of patients are associated with many factors. The aim of the present study was to retrospectively observe the relationship between hematoma shape features and the outcome of patients with spontaneous ICH following sMIS. ⋯ Patients with regular-shaped hematomas exhibited more favorable outcomes. Irregular-shaped hematomas and postoperative residual hematoma volume predicted a poor outcome in patients with ICH following sMIS.
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Catheter-associated urinary tract infections (CAUTIs) account for 25% of all hospital-acquired infections. Neuro-critically ill patients are at 2-5 times greater risk of developing CAUTI because of increased use of indwelling urinary catheters due to neurogenic urinary retention. Despite the heightened risk of CAUTI occurrence for the neuro-critically ill, there is little data on specific characteristics of CAUTIs and risk factors among this population. The aim of this study was to identify characteristics and risk factors associated with CAUTI development in the neuro-critical patient population. ⋯ Stool incontinence, older age, female sex, longer neuroICU LOS and presence of comorbidities such as HTN and diabetes were associated with CAUTI development in the neuro-critically ill population. Average Time-to-CAUTI after catheter placement was 6 days with earlier occurrence if more frequent catheterizations. Colonization of urinary catheters without infection might contribute to CAUTI diagnosis. Prospective research is needed to determine impact of prevention protocols incorporating these factors.