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Keep an eye on the intracranial pressure, thanks to the optic nerve sheath diameter
We report the case of a patient deeply sedated for the management of acute respiratory distress syndrome secondary to pneumonia. Delay in awakening led to cerebral exploration by transcranial Doppler (TCD) and measurement of optic nerve sheath diameter (ONSD). Abnormal values of ONSD prompted immediate brain computed tomography scan that confirmed high intracranial pressure (ICP) due to multiple deep parenchymal hematomas. Despite raised ICP, values obtained by TCD were normal, thanks to the persistence of cerebral autoregulation. This case highlights the interest of combining noninvasive techniques for neurological examin...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Alexandre Vagh Weinmann Charlotte Beaucreux Kevin Kearns Cl & #233;ment Dubost Source Type: research

Hyperammonemia presenting as refractory status epilepticus after lung transplant in a patient positive for Ureaplasma parvum
We present the case of a 65-year-old male with idiopathic pulmonary fibrosis who developed refractory status epilepticus secondary to hyperammonemia following lung transplant. The patient presented on postoperative day 7 with super-refractory status epilepticus and normal computed tomography scan of the head. Hyperammonemia was suspected due to refractory seizures and confirmed with peak ammonia level >1000 μmol/L. Despite aggressive treatment, the patient developed global cerebral edema and died. Postmortem investigations revealed that the patient was positive for Ureaplasma parvum. Additional studi...
Source: Indian Journal of Critical Care Medicine - June 18, 2018 Category: Intensive Care Authors: Diane C McLaughlin Jorge M Mallea Lauren K Ng Source Type: research

Sonographic measurement of optic nerve sheath diameter: How steep is the learning curve for a novice operator ?
Conclusion: Learning curve for novice operators to measure ONSD is steep and they can be taught to measure ONSD in healthy volunteers by sonography in supervised clinical session with an acceptable clinical precision and accuracy comparable to an experienced operator.
Source: Indian Journal of Critical Care Medicine - September 17, 2018 Category: Intensive Care Authors: Gentle Sunder Shrestha Binayak Upadhyay Aanchal Shahi KC Jaya Ram Pankaj Joshi Bishesh Sharma Poudyal Source Type: research

Evaluating extravascular lung water in sepsis: Three lung-ultrasound techniques compared against transpulmonary thermodilution
Conclusion: L-US is feasible in patients with severe sepsis. In addition, L-US 28-zone protocol demonstrated high specificity and better sensitivity than abbreviated 4- and 8-zone protocols. In ARDS, the L-US 28-zone protocol was more accurate than the 4- and 8-zone protocols in predicting EVLW. Consideration of limitations of the latter protocols may prevent clinicians from reaching premature conclusions regarding the prediction of EVLW. Trial Registration: ISRCTN11419081. Registered 4 February 2015 retrospectively.
Source: Indian Journal of Critical Care Medicine - September 17, 2018 Category: Intensive Care Authors: Pattarin Pirompanich Dimitrios Karakitsos Abdulrahman Alharthy Lawrence Marshall Gillman Michael Blaivas Brian M Buchanan Peter G Brindley Anan Wattanathum Source Type: research

Nutrition management of acute postliver transplant recipients
Conclusion: There are scant data on nutrition management in acute post-LT phase. The present study provides the framework for the formulation of continuous, patient-centric, aggressive nutrition management interventions for acute post-LT recipients.
Source: Indian Journal of Critical Care Medicine - November 19, 2018 Category: Intensive Care Authors: Neha Bakshi Kalyani Singh Source Type: research

Fatal iron toxicity in an adult: Clinical profile and review
We report an instance wherein an adult committed suicide by ingestion of multiple iron tablets. Delay in treatment was there due to misdiagnosis of the intoxicating agent. She developed fulminant hepatic failure with rapid clinical deterioration. Despite aggressive supportive management, the patient succumbed to the toxic doses of iron. Clinical course and postmortem features are discussed with a review of the literature.
Source: Indian Journal of Critical Care Medicine - November 19, 2018 Category: Intensive Care Authors: Mandar Ramachandra Sane Kamal Malukani Rashmi Kulkarni Abhishek Varun Source Type: research

Characteristics of patients transported by an air ambulance critical care team
Conclusions This review provides an overview of the characteristics of patients transferred to a major receiving hospital by a prehospital critical care team.
Source: Emergency Medicine Journal - April 12, 2013 Category: Emergency Medicine Authors: Catherall, J. A., Brown, A., Benger, J. R. Tags: Trauma CNS / PNS, Radiology, Adult intensive care, Clinical diagnostic tests, Radiology (diagnostics), Trauma Short report Source Type: research

23.4% Saline Decreases Brain Tissue Volume in Severe Hepatic Encephalopathy as Assessed by a Quantitative CT Marker
Objective: Cerebral edema is common in severe hepatic encephalopathy and may be life threatening. Bolus 23.4% hypertonic saline improves surveillance neuromonitoring scores, although its mechanism of action is not clearly established. We investigated the hypothesis that bolus hypertonic saline decreases cerebral edema in severe hepatic encephalopathy utilizing a quantitative technique to measure brain and cerebrospinal fluid volume changes. Design: Retrospective analysis of serial CT scans, and clinical data for a case-control series were performed. Setting: ICUs of a tertiary care hospital. Patients: Patients with severe ...
Source: Critical Care Medicine - December 18, 2015 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Osmotic Shifts, Cerebral Edema, and Neurologic Deterioration in Severe Hepatic Encephalopathy
Conclusions: Acute decline in osmolality was associated with brain swelling and neurologic deterioration in severe hepatic encephalopathy. Minimizing osmolality decline may avoid neurologic deterioration.
Source: Critical Care Medicine - January 17, 2018 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Retrospective Assessment of Desmopressin Effectiveness and Safety in Patients With Antiplatelet-Associated Intracranial Hemorrhage*
Conclusions: DDAVP was associated with a decreased likelihood of intracranial hemorrhage expansion during the first 24 hours. DDAVP administration did not significantly affect serum sodium and thrombotic events during the study period.
Source: Critical Care Medicine - November 16, 2019 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

American College of Clinical Pharmacy Critical Care Practice and Research Network Travel Awards
The Critical Care PRN will award travel grants to partially support the costs of travel and attendance of a student at the ACCP Annual meeting. Number of Awards Offered: 1 Amount of Each Award: $750.00 Eligibility: To be eligible to apply for the student travel award the candidate must: Be a student member of ACCP Be a full-time pharmacy student pursuing their first professional pharmacy degree at an accredited school of pharmacy Have completed, or demonstrated significant progress in, a critical care related project under the direction of a PRN member Have an abstract accepted for presentation at the An...
Source: ScanGrants feed - June 24, 2013 Category: Research Authors: American College of Clinical Pharmacy Critical Care Practice and Research Network Source Type: funding

American Association of Critical-Care Nurses Grants Program
Applications accepted Sept. 2 through Oct. 31. AACN enthusiastically supports members of our community who seek evidence to support our bedside colleagues in ensuring safety and excellent care for critically ill patients and their families. Funds support research that drives change in high acuity and critical care nursing practice. Awards range from $10,000 to $50,000. Grant applications are accepted annually starting Sept. 2; submission deadline is Oct. 31. Please apply only for one grant. All materials must be submitted online. The portal for submission will be closed at 5 p.m. on Oct. 31. AACN Impact Research G...
Source: ScanGrants feed - July 22, 2014 Category: Research Authors: American Association of Critical-Care Nurses Source Type: funding

SCCM Pod-133 CCM: Human Factors to Medication and Patient Safety in the ICU
Matthew C. Scanlon, MD, discuses his article: Value of human factors to medication and patient safety in the intensive care unit.
Source: SCCM PodCast - iCritical Care - August 2, 2010 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts