Articles: brain-injuries.
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Critical care medicine · Jun 2003
Randomized Controlled Trial Comparative Study Clinical TrialIsovolume hypertonic solutes (sodium chloride or mannitol) in the treatment of refractory posttraumatic intracranial hypertension: 2 mL/kg 7.5% saline is more effective than 2 mL/kg 20% mannitol.
To evaluate the clinical benefit of increasing the osmotic load of the hypertonic solution administered for the treatment of refractory intracranial hypertension episodes in patients with severe head injury. ⋯ In this study, when a hypertonic solute was required for the treatment of refractory intracranial hypertension episodes in patients with severe head trauma, increasing the osmotic load by giving 2 mL/kg (body weight) of 7.5% saline (361 +/- 13 mOsm) was more effective than giving 2 mL/kg (body weight) of 20% mannitol (175 +/- 12 mOsm). Within the limitations of the present study, these data suggest that giving 2 mL/kg hypertonic saline solution (approximately 480 mOsm/70 kg body weight) is an effective and safe initial treatment for intracranial hypertension episodes in head-trauma patients when osmotherapy is indicated.
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Journal of neurosurgery · Apr 2003
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy of antimicrobial-impregnated external ventricular drain catheters: a prospective, randomized, controlled trial.
Catheter-related infection of the cerebrospinal fluid (CSF) pathways is a potentially life-threatening complication of external ventricular drainage. A major source of infection is bacterial contamination along the external ventricular drain (EVD) catheter track. The authors examined the efficacy of EVD catheters impregnated with minocycline and rifampin in preventing these catheter-related infections. ⋯ The use of EVD catheters impregnated with minocycline and rifampin can significantly reduce the risk of catheter-related infections.
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Critical care medicine · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialSafety of sedation with ketamine in severe head injury patients: comparison with sufentanil.
The aim of the study was to compare the safety concerning cerebral hemodynamics of ketamine and sufentanil used for sedation of severe head injury patients, both drugs being used in combination with midazolam. ⋯ The results of this study suggest that ketamine in combination with midazolam is comparable with a combination of midazolam-sufentanil in maintaining intracranial pressure and cerebral perfusion pressure of severe head injury patients placed under controlled mechanical ventilation.
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Nursing in critical care · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialCooling strategies for patients with severe cerebral insult in ICU (Part 2).
Critically ill patients who have sustained a severe cerebral insult will be actively cooled should they develop an elevated body core temperature. Patients who require therapeutic hypothermia for neuroprotection may require the same cooling strategies. ⋯ An experimental approach was used to examine the effects of paracetamol and four external cooling strategies on patients with severe cerebral insult It is suggested that paracetamol is effective in reducing body core temperature and that fans may not. However, data obtained from the study of the four external cooling strategies were inconclusive.
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Intensive care medicine · Jan 2003
Randomized Controlled Trial Clinical TrialThyroid hormone response to moderate hypothermia in severe brain injury.
To examine the effect of controlled moderate hypothermia on thyroid response in head-injured patients. ⋯ Thyroid hormone patterns during moderate hypothermia in head-injured patients did not differ from the well known "low T3 state" which is observed in other forms of severe illness.