Articles: cations.
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Prior studies have shown worse outcomes in patients with cardiogenic shock (CS) who have reduced left ventricular ejection fraction (LVEF), but the association between other transthoracic echocardiogram (TTE) findings and mortality in CS patients remains uncertain. We hypothesized that Doppler TTE measurements would outperform LVEF for risk stratification. ⋯ Early comprehensive Doppler TTE can provide important prognostic insights in CS patients, highlighting its potential utility in clinical practice. The LVOT VTI, reflecting forward flow, is an important measurement to obtain on bedside TTE.
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Avoiding the Radial Paradox: Neuroendovascular Femoral Access Outcomes After Radial Access Adoption.
Transradial access (TRA) for neuroendovascular procedures is increasing in prevalence. The safety benefits of TRA at a patient level may be offset at a population level by a paradoxical increase in transfemoral access (TFA) vascular access site complications (VASCs), the so-called "radial paradox." ⋯ TFA remains an important access route, despite a predominantly radial paradigm, and is disproportionately used in patients at increased risk for VASCs. TFA proficiency may still be achieved in predominantly radial practices without an increase in femoral complications.
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Isolated traumatic subarachnoid hemorrhage (tSAH) is a common finding in mild traumatic brain injury that often results in transfer to a tertiary center. Patients prescribed blood-thinning medications (BTs) are believed to be at higher risk of clinical or radiographic worsening. ⋯ Neurologically intact patients on BTs with isolated tSAH are not at increased risk of radiographic progression or neurosurgical intervention. The presence of BTs should not influence management decisions for increased surveillance.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Mar 2022
[Artificial Intelligence: Challenges and Applications in Intensive Care Medicine].
The high workload in intensive care medicine arises from the exponential growth of medical knowledge, the flood of data generated by the permanent and intensive monitoring of intensive care patients, and the documentation burden. Artificial intelligence (AI) is predicted to have a great impact on ICU work in the near future as it will be applicable in many areas of critical care medicine. These applications include documentation through speech recognition, predictions for decision support, algorithms for parameter optimisation and the development of personalised intensive care medicine. ⋯ Speech recognition has the potential to reduce this documentation burden. It is not yet precise enough to be usable in the clinic. The application of AI in medicine, with the help of large data sets, promises to identify diagnoses more quickly, develop individualised, precise treatments, support therapeutic decisions, use resources with maximum effectiveness and thus optimise the patient experience in the near future.
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Case Reports
Microsurgical treatment for a Cerebral Arteriovenous Malformation of the Central Sulcus.
Arteriovenous malformations (AVMs) are congenital neurovascular disorders frequently manifested in young adults. The clinical presentation is variable and depends on its location, size, and ability to steal flow from adjacent areas, but it depends mainly on the occurrence of bleeding.1 The treatment of these lesions when located in eloquent areas, especially around the central sulcus, is controversial. ⋯ We consider that surgical removal of many of these lesions is feasible when preoperative planning is performed,3 when it is based on deep anatomic knowledge, and particularly when using a refined microsurgical technique.1 In this 3-dimensional Video 1, we present a case of a cerebral AVM of the central sulcus in which we achieved complete resection with microsurgical treatment without any neurologic sequelae for the patient. The patient consented to publication of images.