Ethical issues in neuroprognostication after severe pediatric brain injury

A 4 month old girl with no significant past medical history had a cardiac arrest at home. Her parents found her unresponsive, face down in her playpen, and not breathing. She was last seen 20minutes prior. Her father performed CPR for 5minutes and EMS continued CPR for an additional 2-3minutes. Spontaneous circulation returned after 1 dose of epinephrine. She was intubated and taken to the emergency room where she was noted to have seizure-like movements in her right arm and eye twitching. She received 2 doses of lorazepam and was started on dopamine prior to transfer to the pediatric intensive care unit, where she was placed on a therapeutic hypothermia protocol.
Source: Seminars in Pediatric Neurology - Category: Neurology Authors: Source Type: research

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ConclusionsThe differential antagonism of rate ‐decreasing and hypothermic effects implicates differential involvement of nAChR subtypes. The decreased capacity of mecamylamine and DHβE to antagonize nicotine during chronic nicotine treatment may indicate that their effectiveness as smoking cessations might vary as a function of nicotine tole rance and dependence.
Source: Brain and Behavior - Category: Neurology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Purpose: The purpose of this integrative review was to assess common warming measures used for prevention of hypothermia during the perioperative period for women having cesarean birth and to determine their efficacy. Methods: A literature search was conducted via electronic databases EBSCO, PUBMED, Academic Search Premier, Google Scholar, and CINAHL using keyword search terms hypothermia, cesarean, and warming. Inclusion criteria were articles written in English and published between 2006 and 2018. Results: Seventeen articles were included in the review, covering three common warming measures; intravenous (IV) flu...
Source: MCN: The American Journal of Maternal Child Nursing - Category: Nursing Tags: Feature Source Type: research
(Eur J Anaesthesiol. 2019;36:442–448)
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research
Preventing the frequent perioperative hypothermia incidents that occur during elective caesarean deliveries would be beneficial. This trial aimed at evaluating the effect of preoperative forced-air warming alo...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
Conditions:   Hypothermia;   Exercise Test;   Cognition Interventions:   Drug: Methylphenidate;   Drug: Placebo oral tablet Sponsor:   Brock University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsThe majority of these patients were managed without clinically significant perioperative complications. As previously reported, bradycardia, hypotension, and hypothermia were the most common adverse events. Routine avoidance of propofol in patients with Batten disease does not appear warranted.
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
Conclusions: In the wake of the era of TH, MRI and neurophysiological tests (aEEG or EEG) were promising predictors of adverse outcomes, while SEPs need high-quality studies to confirm the findings. Continued follow-up of the children and well-designed large prospective studies are essential to determine whether these benefits are maintained in later childhood.
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Gholami A, Mousavi SM, Hashemi SA, Ghasemi Y, Chiang WH, Parvin N Abstract Nowadays, magnetic nanoparticles (MNPs) have been rapidly investigated and attracted worldwide attention due to their great potential as mediators of heat for treating hyperthermia and their possibility to deliver drugs at specific locations, which can thereby limit systematic effects. Cancer therapy via MNPs proposes novel properties rather than normal methods such as almost zero side effects and a high-efficiency rate of effectiveness. The key aim of targeted drug delivery is to reduce side effects of the main cancer treatment tha...
Source: Drug Metabolism Reviews - Category: Drugs & Pharmacology Tags: Drug Metab Rev Source Type: research
Publication date: April 2020Source: Epilepsy &Behavior, Volume 105Author(s): Vivek Sabharwal, Mugilan Poongkunran, Murad Talahma, Ifeanyi O. Iwuchukwu, Eugene Ramsay, Fawad Khan, Uma Menon, Giuseppe Ciccotto, Namir Khandker, Harold McGradeAbstractBackgroundTherapeutic hypothermia as a potent nonpharmacologic antiseizure therapy has been investigated experimentally in animal models and humans. Although induced hypothermia has been shown to be neuroprotective in acute convulsive status epilepticus, whether its use will translate into improved outcomes for patients with super-refractory nonconvulsive status epilepticus (S...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Targeted temperature management (TTM) is used frequently in patients with a variety of diseases, especially those who have experienced brain injury and/or cardiac arrest. Shivering is one of the main adverse effects of TTM that can often limit its implementation and efficacy. Shivering is the body's natural response to hypothermia and its deleterious effects can negate the benefits of TTM. The purpose of this article is to provide an overview of TTM strategies and shivering management.
Source: Critical Care Nursing Quarterly - Category: Nursing Tags: Original Articles Source Type: research
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