Neurology Critical Care
Coma/Anoxic Brain Injury
Levy DE, Caronna JJ, Singer BH, et al. Predicting outcome from hypoxic-ischemia coma. JAMA 1985;253:1420-6. Oft-cited landmark study of the prognostic information provided by physical examination.
PMID: 3968772
Wijdicks EF, Hijdra A, Young GB, et al. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006 ;67:203-10. Excellent, practical review from the AAN.
PMID: 16864809
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Coplin WM, Pierson DJ, Cooley KD, et al. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. Am J Respir Crit Care Med 2000;161:1530-6. Prospective cohort study found patients with "delayed" extubation had increased incidence of nosocomial pneumonia, longer ICU and hospital stays, and greater hospital charges.
PMID: 10806150
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Therapeutic hypothermia following cardiac arrest
The following simultaneously-published studies found reducing core body temperature to 32°C to 34°C improved neurologic outcomes in comatose survivors of cardiac arrest:
Bernard SA, Gray TW, Buist MD, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002; 346:557-63.
PMID: 11856794
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The Hypothermia After Cardiac Arrest Study Group. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002; 346:549-56.
PMID: 11856793
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Acute stroke
van Gijn J, Kerr RS, Rinkel GJ. Subarachnoid haemorrhage. Lancet 2007;27;369:306-18. Review of the evaluation, treatment, and complications of vasospasm and rebleeding.
PMID: 17258671
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Broderick J, Connolly S, Feldmann E, et al. Guidelines for the management of spontaneous intracerebral hemorrhage in adults: 2007 update: a guideline of the AHA and ASA. Stroke 2007; 38:2001-23. Guidelines offer primarily expert-opinion based recommendations and acknowledge the lack of available evidence to guide medical management. Published prior to more recent studies showing recombinant factor VII does not improve clinical outcomes.
PMID: 17938297
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Adams HP Jr, del Zoppo G, Alberts MJ, et al. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: Most recent guidelines for the management of ischemic stroke. Circulation. 2007;115:e478-534.
PMID: 17515473
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ICU-acquired weakness
Griffiths RD and Hall JB. Intensive care unit-acquired weakness. Crit Care Med 2010;38:779-87. An updated review of ICU-acquired weakness that offers concise summaries of risk factors, pathophysiology, and prevention, including early mobilization.
PMID: 20048676
***See also Ventilation and Weaning
Other
DeGans J, van de Beek D. Dexamethasone in adults with bacterial meningitis. N Engl J Med 2002; 347:1549-56. High quality RCT including 301 patients found early administration of 10 mg dexamethasone q 6 hrs for 4 days reduced the risk of poor outcome (score of 5 vs. score of 1-4 on Glasgow Outcome Scale) [relative risk 0.59] and was associated with a relative risk of death of 0.48.
PMID: 12432041
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