Articles: brain-injuries.
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Journal of neurosurgery · May 2010
Meta AnalysisRelationship of aggressive monitoring and treatment to improved outcomes in severe traumatic brain injury.
Despite being common practice for decades and being recommended by national guidelines, aggressive monitoring and treatment of patients with severe traumatic brain injury (TBI) have not been supported by convincing evidence. ⋯ Aggressive ICP monitoring and treatment of patients with severe TBI is associated with a statistically significant improvement in outcome. This improvement occurs independently of temporal effects.
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Acquired brain injury (ABI) can result in impairments in motor function, language, cognition, sensory processing and emotional disturbances. This may severely reduce a survivor's quality of life. Music therapy has been used in rehabilitation to stimulate brain functions involved in movement, cognition, speech, emotions and sensory perceptions. A systematic review is needed to gauge the efficacy of music therapy as a rehabilitation intervention for people with ABI. ⋯ RAS may be beneficial for gait improvement in people with stroke. These results are encouraging, but more RCTs are needed before recommendations can be made for clinical practice. More research is needed to examine the effects of music therapy on other outcomes in people with ABI.
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Review Meta Analysis
Systematic review of the literature on pain in patients with polytrauma including traumatic brain injury.
To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. ⋯ Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.
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J Intensive Care Med · Mar 2009
Meta AnalysisBrain injury and fever: hospital length of stay and cost outcomes.
Fever has been shown to be related to extended hospital stays in neurologically injured patients. We performed meta-analyses of the impact of fever on length of stay (LOS) in the Intensive Care Unit (ICU) and for total hospital length of stay, including all recent scholarship published since 1/1/1995 pertaining to thermoregulation of neurogenic fever and length of hospital stay. We also developed estimates of the financial impact on hospital costs. ⋯ For hospital LOS, g = .79, Z = 2.2, P = .0278. Mean additional ICU days = 5.7 days; mean additional hospital days = 8.5 days. We estimate that fever added an average of $17,414 in hospital cost to total hospital stays; mean $13,672 (95% Confidence Interval [CI]: $10,074, $17,270) in additional ICU costs and mean $3,742 (CI: -$1,203, $8,820) in additional routine costs.
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Meta Analysis Comparative Study Clinical Trial
Infra-red thermometry: the reliability of tympanic and temporal artery readings for predicting brain temperature after severe traumatic brain injury.
Temperature measurement is important during routine neurocritical care especially as differences between brain and systemic temperatures have been observed. The purpose of the study was to determine if infra-red temporal artery thermometry provides a better estimate of brain temperature than tympanic membrane temperature for patients with severe traumatic brain injury. ⋯ At temperatures within the normal to febrile range, temporal artery temperature is closer to brain temperature than is tympanic membrane temperature.