Neurocritical care
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Randomized Controlled Trial Multicenter Study
Association between disability measures and short-term health care costs following intracerebral hemorrhage.
Small improvements in clinical outcomes after intracerebral hemorrhage (ICH) can have a substantial impact on overall health care costs, yet little data exists on the costs associated with the most commonly studied clinical outcomes in this type of stroke. ⋯ Health care costs vary significantly by levels of disability as measured by the mRS, but costs do not vary across the full range of mRS outcomes. The mRS is more informative than the Barthel index and NIHSS for discriminating the resource use and costs associated with different levels of disability after ICH.
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Multicenter Study
Aggressive red blood cell transfusion: no association with improved outcomes for victims of isolated traumatic brain injury.
Clinical studies have caused blood transfusion practices in critically ill patients to become more conservative in the last decade. However, few studies have focused on trauma patients, particularly those with severe isolated traumatic brain injury. ⋯ Our results suggest that a restrictive transfusion practice is safe for severely head-injured patients.
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Randomized Controlled Trial Multicenter Study
Recombinant activated factor VII for acute intracerebral hemorrhage: US phase IIA trial.
Ultra-early hemostatic therapy may improve outcome after intracerebral hemorrhage (ICH) by preventing rebleeding and hematoma expansion. We conducted this trial to evaluate the safety of activated recombinant factor VII (rFVIIa; NovoSeven) for preventing early hematoma growth in acute ICH. ⋯ Ultra-early rFVIIa treatment for ICH was associated with a reasonable safety profile in this preliminary study across a wide range of dosages. Further research is warranted to investigate the safety and potential efficacy of rFVIIa for minimizing ICH growth.
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Randomized Controlled Trial Multicenter Study
Effect of a liberal versus restrictive transfusion strategy on mortality in patients with moderate to severe head injury.
To compare a restrictive versus a liberal transfusion strategy in patients with moderate to severe closed head injury following multiple trauma in 13 Canadian intensive care units (ICUs). ⋯ We were unable to detect significant improvements in mortality with a liberal as compared to restrictive transfusion strategy in critically ill trauma victims with moderate to severe head injury.