Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Apr 2022
Brain Tissue Oxygen Response as Indicator for Cerebral Lactate Levels in Aneurysmal Subarachnoid Hemorrhage Patients.
Early detection of cerebral ischemia and metabolic crisis is crucial in critically ill subarachnoid hemorrhage (SAH) patients. Variable increases in brain tissue oxygen tension (PbtO2) are observed when the fraction of inspired oxygen (FiO2) is increased to 1.0. The aim of this prospective study was to evaluate whether a 3-minute hyperoxic challenge can identify patients at risk for cerebral ischemia detected by cerebral microdialysis. ⋯ A 3-minute FiO2 challenge is an easy to perform and feasible bedside diagnostic tool in SAH patients. The absolute increase in PbtO2 during the FiO2 challenge might be a useful surrogate marker to estimate cerebral lactate concentrations and might be used to identify patients at risk for impending ischemia.
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J Neurosurg Anesthesiol · Apr 2022
Early Lymphopenia and Infections in Nontraumatic Subarachnoid Hemorrhage Patients.
Subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality. A certain degree of immunodepression has been reported during critical illness, and lymphopenia identified as an independent predictor of poor outcome; no data are available for critically ill SAH patients. We aimed to evaluate the prevalence of lymphopenia among SAH patients and its association with hospital-acquired infection. ⋯ Early lymphopenia is common after SAH, but is not significantly associated with the development of infections or with poor outcome.
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J Neurosurg Anesthesiol · Apr 2022
Randomized Controlled TrialEffect of Electroencephalography Spectral Edge Frequency (SEF) and Patient State Index (PSI)-Guided Propofol-Remifentanil Anesthesia on Delirium After Laparoscopic Surgery: The eMODIPOD Randomized Controlled Trial.
The effect of SedLine electroencephalography (EEG)-guided anesthetic care on postoperative delirium (POD) has not been studied. ⋯ Compared with usual care, SedLine spectral edge frequency-guided and patient state index-guided propofol-remifentanil anesthetic care neither alters anesthetic delivery nor decreases the unexpected low incidence of POD in relatively young Chinese patients undergoing laparoscopic surgery.
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J Neurosurg Anesthesiol · Apr 2022
Observational StudyCorrelation Between Invasive and Noninvasive Technique of Intracranial Pressure Measurement in Children With Traumatic Brain Injury: An Observational Study.
Direct measurement of intracranial pressure (ICP) is an invasive technique with potential complications, which has prompted the development of alternative, noninvasive, methods of ICP assessment. The aim of this study was to determine the relationship between noninvasive ultrasound-based measurement of optic nerve sheath diameter (ONSD), transcranial Doppler-derived pulsatility index (PI), and invasive ICP measurements in children with traumatic brain injury (TBI). ⋯ In children with TBI, a combination of ONSD and PI strongly correlates with invasive ICP and has potential to screen for intracranial hypertension noninvasively. ONSD and PI may be useful tools for assessing ICP where invasive monitoring is unavailable or contraindicated.
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J Neurosurg Anesthesiol · Apr 2022
Perceptions Regarding the SARS-CoV-2 Pandemic's Impact on Neurocritical Care Delivery: Results From a Global Survey.
The SARS-CoV-2 (COVID-19) pandemic has impacted many facets of critical care delivery. ⋯ This study reports the perceived impact of the COVID-19 pandemic on global neurocritical care delivery, and highlights shortcomings of health care infrastructures and the importance of pandemic preparedness.