The Current State of Workforce Diversity and Inclusion in Pediatric Critical Care
Literature suggests the pediatric critical care (PCC) workforce includes limited providers from groups underrepresented in medicine (URiM; African American/Black, Hispanic/Latinx, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). Additionally, women and providers URiM hold fewer leadership positions regardless of health-care discipline or specialty. Data on sexual and gender minority representation and persons with different physical abilities within the PCC workforce are incomplete or unknown. More data are needed to understand the true landscape of the PCC workforce across disciplines. Efforts to increase...
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Yuen Lie Tjoeng, Carlie Myers, Sharon Y. Irving, Ivie Esangbedo, Derek Wheeler, Ndidiamaka Musa Source Type: research

Taking the Pulse of the Current State of Simulation
Simulation in health-care professions has grown in the last few decades. We provide an overview of the history of simulation in other fields, the trajectory of simulation in health professions education, and research in medical education, including the learning theories and tools to assess and evaluate simulation programs. We also propose future directions for simulation and research in health professions education. (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Anisha Kshetrapal, Mary E. McBride, Candace Mannarino Source Type: research

Neuroprognostication
Patients with severe acute brain injury are left incapacitated, critically ill, and unable to make their own medical decisions. Surrogate decision-makers must make life-or-death decisions for patients and rely on clinicians ’ prognostication for guidance. No guidelines currently exist to guide clinicians in how to prognosticate; hence, neuroprognostication is still considered an “art” leaving room for high variability. This review examines the current literature on prognostication in neurocritical care, identifie s ongoing challenges that exist in the field, and provides suggestions for future research with the goal ...
Source: Critical Care Clinics - October 13, 2022 Category: Intensive Care Authors: Victoria Fleming, Susanne Muehlschlegel Source Type: research

Neurocritical Care Education in the United States
This article will review the history and current state of neurocritical care training and education, physician certification, and program accreditation in the United States within the larger context of critical care training across subspecialties. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 13, 2022 Category: Intensive Care Authors: Angela Hays Shapshak, Lori Shutter Source Type: research

Neurotrauma and Intracranial Pressure Management
This article will review keys concepts to interpret and apply published ICP management guidelines and statements. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 13, 2022 Category: Intensive Care Authors: Francis Bernard Source Type: research

Artificial Intelligence and Big Data Science in Neurocritical Care
In recent years, the volume of digitalized web-based information utilizing modern computer-based technology for data storage, processing, and analysis has grown rapidly. Humans can process a limited number of variables at any given time. Thus, the deluge of clinically useful information in the intensive care unit environment remains untapped. Innovations in machine learning technology with the development of deep neural networks and efficient, cost-effective data archival systems have provided the infrastructure to apply artificial intelligence on big data for determination of clinical events and outcomes. Here, we introdu...
Source: Critical Care Clinics - October 9, 2022 Category: Intensive Care Authors: Shraddha Mainali, Soojin Park Source Type: research

Brain Death/Death by Neurological Criteria
This article reviews the criteria for determination of brain death, discusses the importance of protocol development, and reviews the international efforts to standardize clinical testing. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 9, 2022 Category: Intensive Care Authors: Gene Sung Source Type: research

Neuromuscular Weakness in Intensive Care
Diseases of the peripheral nervous system create an additional diagnostic conundrum within the intensive care setting. Causes are vast, presentations are myriad, and symptoms are often ill-defined or misidentified. Care benefits from a multidisciplinary approach including a neuromuscular specialist, rehabilitation services, and a specialty pharmacist in addition to the neurocritical care team. In general, survivors achieve a good functional recovery relative to their preintensive care unit baseline. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 6, 2022 Category: Intensive Care Authors: Deepa Malaiyandi, Elysia James Source Type: research

Status Epilepticus
In this review, we discuss treatment and considerations for status epilepticus in general intensive care unit patients, acquired brain injury, autoimmune conditions, toxidromes, pediatrics, and pregnancy. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 6, 2022 Category: Intensive Care Authors: Patrick J. Coppler, Jonathan Elmer Source Type: research

Neurocritical Care Research
One of the most common questions asked by family members of patients with brain injuries who are in a coma is “will my loved one wake up?”. Despite substantial improvements in the care of patients with neurological diseases, the medical and scientific community struggles to answer this simple question. More importantly, the technology and treatment strategies to improve the trajectory of patients with i mpaired consciousness in the acute setting are limited. The Curing Coma Campaign was developed by the Neurocritical Care Society as a multispecialty, multi-interest community of researchers and caretakers who are focuse...
Source: Critical Care Clinics - October 6, 2022 Category: Intensive Care Authors: Jose Javier Provencio Source Type: research

Neurocritical Care in the General Intensive Care Unit
This article will discuss some of the more common neurologic issues encountered and provide guidance in the assessment and management of these conditions. (Source: Critical Care Clinics)
Source: Critical Care Clinics - October 3, 2022 Category: Intensive Care Authors: Firas Abdulmajeed, Mohanad Hamandi, Deepa Malaiyandi, Lori Shutter Source Type: research

Neurocritical Care Aspects of Ischemic Stroke Management
This article reviews the care of patients with ischemic stroke in the intensive care unit, including early general critical care interventions for airway control blood pressure goals according to the type of acute stroke treatment, poststroke cerebral edema management, hemorrhagic conversion in ischemic stroke, fibrinolytic reversal, and management of carotid endarterectomy and infective endocarditis. The importance of preventing common intensive care complications is discussed, including aspiration pneumonia, deep venous thrombosis, urinary tract infections, cardiac arrhythmias, and hyperglycemia. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 30, 2022 Category: Intensive Care Authors: Dania Qaryouti, Diana Greene-Chandos Source Type: research

Neuropharmacology in the Intensive Care Unit
This article provides clinicians with general pharmacologic knowledge of the following drug regimens commonly prescribed to neurocritically ill adults: sedatives, analgesics, osmotherapy, antiseizure medications, antishivering agents, vasoactive agents, and antithrombotic reversal agents. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 30, 2022 Category: Intensive Care Authors: Abdalla Ammar, Mahmoud A. Ammar, Eljim P. Tesoro Source Type: research

Advances in Intracranial Hemorrhage
Aneurysmal subarachnoid hemorrhage and intracerebral hemorrhage are devastating injuries causing significant morbidity and mortality. However, advancements made over decades have improved outcomes. This review summarizes a systematic approach to stabilize and treat these patient populations. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 29, 2022 Category: Intensive Care Authors: Salvatore A. D ’Amato, Tiffany R. Chang Source Type: research

Physiological Monitoring in Patients with Acute Brain Injury
Neurocritical care management of acute brain injury (ABI) is focused on identification, prevention, and management of secondary brain injury (SBI). Physiologic monitoring of the brain and other organ systems has a role to predict patient recovery or deterioration, guide individualized therapeutic interventions, and measure response to treatment, with the goal of improving patient outcomes. In this review, we detail how specific physiologic markers of brain injury and neuromonitoring tools are integrated and used in ABI patients to develop therapeutic approaches to prevent SBI. (Source: Critical Care Clinics)
Source: Critical Care Clinics - September 29, 2022 Category: Intensive Care Authors: Tracey H. Fan, Eric S. Rosenthal Source Type: research