Neurocritical care
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It remains a challenge to judge whether comatose patients with acute intracerebral hemorrhage (ICH) can wake up. Here, we aimed to investigate the changes in right ventricle-pulmonary artery (RV-PA) coupling over time in these patients and to evaluate its performance for discriminating between those who woke up within 60 days and those who did not. ⋯ Right ventricle-pulmonary artery coupling demonstrated a high performance for discriminating comatose patients with ICH who woke up within 60 days from those who did not.
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Coagulopathy is often observed in severe traumatic brain injury (sTBI), and hyperfibrinolysis (HF) is associated with a poor prognosis. Although the efficacy of fibrinogen concentrate (FC) in multiple trauma has been reported, its efficacy in sTBI is unclear. Therefore, we delineated severe HF risk factors despite fresh frozen plasma transfusion. Using these risk factors, we defined high-risk patients and determined whether FC administration to this group improved fibrinogen level. ⋯ Coagulation abnormalities on arrival, severe skull fracture, and multiple trauma are severe HF risk factors. FC administration may contribute to rapid correction of developing hypofibrinogenemia.