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Neurology Critical CareGeneral reviews and status epilepticus Provencio JJ, Bleck TP, Connors AF. Critical care neurology. Am J Respir Crit Care Med 2001; 164:341-5. Provides an update on the management of neuromuscular diseases, CVA, spinal cord injury, and status epilepticus. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11500331 Coma/Anoxic Brain Injury Zanbergen EGJ, de Haan RJ, Stoutenbeek CP, et al. Systematic review of early predictors of poor outcome in anoxic-ischemic coma. Lancet 1998;352:1808-12. Focuses on the utility of physical exam, EEG, and evoked potentials in hypoxic and traumatic coma. Most studies on this topic limited by self-fulfilling nature of withdrawing support based on prognostic criteria. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9851380 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. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10806150 ***See also Cardiology (Hypothermia section) Delirium Ely EW, Shintani A, Truman B, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 2004;291:1753-62. This study confirmed a high prevalence of ICU delirium and was the first to show delirium is an independent risk factor for mortality. Specifically, ICU delirium was associated with 3-fold higher 6-month mortality. After adjusting for co-morbidities, illness severity, coma, and use of sedatives and analgesics, delirium was also associated with prolonged ICU and hospital stays, as well as cognitive impairment at hospital discharge. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15082703&query_hl=16&itool=pubmed_DocSum Spinal cord injury Intracranial pressure elevation 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. 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. http://www.ncbi.nlm.nih.gov/pubmed/17515473?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2 Deem S, Lee CT, Curtis JR. Acquired neuromuscular disorders in the ICU. Am J Respir Crit Care Med 2003;168:735-9. Succint overview of common causes of weakness associated with critical illness. There are few large prospective studies performed in this area to date. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14522811 *See also Noninvasive Ventilatory Support for pulmonary complications of neuromuscular weakness. | |||||||||
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