Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2020
Observational StudyNoninvasive Intracranial Pressure Estimation With Transcranial Doppler: A Prospective Observational Study.
Transcranial Doppler (TCD) ultrasonography has been described for the noninvasive assessment of intracranial pressure (ICP). This study investigates the relationship between standard, invasive intracranial pressure monitoring (ICPi) and noninvasive ICP assessment using a simple formula based on TCD-derived flow velocity (FV) and mean arterial blood pressure values (ICPTCD). ⋯ Using a formula based on diastolic FV, TCD is an insufficiently accurate method for the noninvasive assessment of ICP. Further studies are warranted to confirm these results in a broader patient cohort.
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J Neurosurg Anesthesiol · Oct 2020
Observational StudyEffective Cerebral Perfusion Pressure: Does the Estimation Method Make a Difference?
The effective cerebral perfusion pressure (CPPe), zero-flow pressure (ZFP), and resistance area product (RAP) are important determinants of cerebral blood flow. ZFP and RAP are usually estimated by linear regression analysis of pressure-velocity relationships of the middle cerebral artery. The aim of this study was to validate 4 other estimation methods against the standard linear regression method. ⋯ CPPe, ZFP, and RAP measurements based on 2 alternative calculation methods are comparable to the linear regression reference method.
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J Neurosurg Anesthesiol · Oct 2020
Effect of Daytime Versus Night-time on Outcome in Patients Undergoing Emergent Neurosurgical Procedures.
Timing of neurosurgical procedures is controversial. Challenges identified with night-time surgeries include physician fatigue and sleep deprivation, and fewer staff and resources compared with daytime surgery. These might contribute to medical errors and complications, and, hence, worse patient outcomes. ⋯ This study found no difference in the rate of unfavorable neurological outcome in patients undergoing emergent neurosurgical procedures during the daytime and night-time. However, our findings cannot exclude the possibility of an association between timing of surgery and outcome given its limitations, including small sample size and omission of potentially confounding variables. Further well-designed prospective trials are warranted to confirm our findings.