Articles: monitoring.
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Pol. Arch. Med. Wewn. · Jan 2025
Assessment of regional cerebral oxygen saturation and ETCO2 in prediction of the return of spontaneous circulation and patients outcome after in-hospital cardiac arrest.
Cerebral oximetry measurement using near-infrared spectroscopy (NIRS) has been highlighted as a technology that can provide noninvasive information on regional cerebral oxygen saturation (rSO2) during CPR even though its effectiveness has not been fully confirmed. The research focuses on the use of NIRS to predict the return of spontaneous circulation (ROSC) and neurological outcomes. ⋯ The rSO2 value is a more sensitive indicator of ROSC compared to ETCO2. Higher rSO2 values are associated with a higher probability of achieving ROSC. The monitoring of rSO2 during CPR provides prognostic information.
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Status epilepticus is a common neurological emergency that is characterised by prolonged or recurrent seizures without recovery between episodes and associated with substantial morbidity and mortality. Prompt recognition and targeted therapy can reduce the risk of complications and death associated with status epilepticus, thereby improving outcomes. The most recent International League Against Epilepsy definition considers two important timepoints in status epilepticus: first, when the seizure does not self-terminate; and second, when the seizure can have long-term consequences, including neuronal injury. ⋯ If status epilepticus continues, management should entail second-line and third-line treatment agents, supportive EEG monitoring, and admission to an intensive care unit. Future research to study early seizure detection, rescue protocols and medications, rapid treatment escalation, and integration of fundamental scientific and clinical evidence into clinical practice could shorten seizure duration and reduce associated complications. Furthermore, improved recognition, education, and treatment in patients who are at risk might help to prevent status epilepticus, particularly for patients living in low-income and middle-income countries.
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Multicenter Study
Intraoperative hypoglycemia among adults with intraoperative glucose measurements: a cross-sectional multicentre retrospective cohort study.
Intraoperative hypoglycemia is presumed to be rare, but generalizable multicentre incidence and risk factor data for adult patients are lacking. We used a multicentre registry to characterize adults with intraoperative hypoglycemia and hypothesized that intraoperative insulin administration would be associated with hypoglycemia. ⋯ In this large cross-sectional retrospective multicentre cohort study, intraoperative hypoglycemia was a rare event. Intraoperative insulin use was not associated with hypoglycemia.