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Stroke Risk Following Infection in Patients with Continuous-Flow Left Ventricular Assist Device
ConclusionsLVAD infections, particularly BSI, are significantly associated with stroke, and infection-related stroke conferred significantly lower cumulative survival.
Source: Neurocritical Care - January 14, 2019 Category: Neurology Source Type: research

Mechanical Ventilation for Acute Stroke: A Multi-state Population-Based Study
Conclusions In this large population-based sample, over half of mechanically ventilated stroke patients died in the hospital despite the fact that younger patients were more likely to receive mechanical ventilation. Future studies are indicated to elucidate mechanical ventilation strategies to optimize long-term outcomes after severe stroke.
Source: Neurocritical Care - December 9, 2014 Category: Neurology Source Type: research

Diagnostic Accuracy of Glial Fibrillary Acidic Protein and Ubiquitin Carboxy - Terminal Hydrolase - L1 Serum Concentrations for Differentiating Acute Intracerebral Hemorrhage from Ischemic Stroke
ConclusionsGFAP may differentiate ICH from ischemic stroke and stroke mimics. A point-of-care test to distinguish between ischemic and hemorrhagic strokes might facilitate triage to different treatment pathways or locations, or be used to select patients for trials of ultra-early interventions.
Source: Neurocritical Care - February 23, 2020 Category: Neurology Source Type: research

Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System
ConclusionWe observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in patients with COVID-19 infection occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in patients with COVID-19.
Source: Neurocritical Care - August 23, 2020 Category: Neurology Source Type: research

Hospital Length of Stay and 30-Day Mortality Prediction in Stroke: A Machine Learning Analysis of 17,000 ICU Admissions in Brazil
ConclusionsHospital length of stay and 30-day mortality of patients admitted to the ICU with stroke were accurately predicted through machine learning methods, even in the absence of stroke-specific data, such as the National Institutes of Health Stroke Scale score or neuroimaging findings. The proposed methods using general intensive care databases may be used for resource use allocation planning and performance assessment of ICUs treating stroke. More detailed acute neurological and management data, as well as long-term functional outcomes, may improve the accuracy and applicability of future machine-learning-based prediction algorithms.
Source: Neurocritical Care - April 6, 2022 Category: Neurology Source Type: research

Initial Conservative Management of Severe Hemispheric Stroke Reduces Decompressive Craniectomy Rates
Conclusions Delayed DC for hemispheric stroke patients managed under protocol in the neurocritical care unit is a safe alternative to early, prophylactic DC for adults with severe hemispheric stroke. This strategy reduced DC rates by 60 % without an excess of death or survival with severe disabilities.
Source: Neurocritical Care - April 20, 2016 Category: Neurology Source Type: research

Stroke and Intracranial Hemorrhage in HeartMate II and HeartWare Left Ventricular Assist Devices: A Systematic Review
ConclusionsIschemic stroke and ICH are common after LVAD placement, but heterogeneous event rates are reported in the literature. Given the high associated mortality, further prospective study is warranted.
Source: Neurocritical Care - July 25, 2017 Category: Neurology Source Type: research

Outcomes of Acute Stroke Patients Requiring Mechanical Ventilation: Study Protocol for the SPICE Multicenter Prospective Observational Study
ConclusionsThe SPICE multicenter study will investigate 1-year outcomes, ethical issues, as well as care pathways of acute stroke patients requiring invasive ventilation in the ICU. Gathered data will delineate human resources and facilities needs for adequate management. The identification of prognostic factors at the acute phase will help to identify patients who may benefit from prolonged intensive care and rehabilitation.Trial registration: NCT03335995.
Source: Neurocritical Care - February 4, 2020 Category: Neurology Source Type: research

Prior Thrombectomy Does Not Affect the Surgical Complication Rate of Decompressive Hemicraniectomy in Patients with Malignant Ischemic Stroke
ConclusionsA prior mechanical recanalization with possibly associated systemic thrombolysis does not affect the early surgical complication rate and the functional outcome after decompressive hemicraniectomy for malignant ischemic stroke. Patient characteristics have not changed significantly since the introduction of mechanical recanalization; therefore, the results from former large randomized controlled trials are still valid in the modern era of stroke care.
Source: Neurocritical Care - August 28, 2023 Category: Neurology Source Type: research

Decannulation and Functional Outcome After Tracheostomy in Patients with Severe Stroke (DECAST): A Prospective Observational Study
ConclusionsDecannulation was achieved in 59.4% of stroke patients surviving the first 12  months after tracheostomy and was associated with better functional outcome compared to patients without decannulation. Further prospective studies with larger sample sizes are needed to confirm our results.
Source: Neurocritical Care - July 25, 2017 Category: Neurology Source Type: research

Amantadine and Modafinil as Neurostimulants Following Acute Stroke: A Retrospective Study of Intensive Care Unit Patients
ConclusionsNeurostimulant administration during acute stroke care may improve wakefulness. Future controlled studies with a neurostimulant administration protocol, prospective evaluation, and discretely defined response and safety criteria are needed to confirm these encouraging findings.
Source: Neurocritical Care - May 19, 2020 Category: Neurology Source Type: research

Comparison of Clevidipine and Nicardipine for Acute Blood Pressure Reduction in Hemorrhagic Stroke
ConclusionsIn patients with hemorrhagic stroke, nicardipine appeared to have similar efficacy as clevidipine in SBP reduction, with a more likely reduction of rebound hypertension and drug cost. This retrospective study was underpowered, which may limit these implications. Further prospective studies are warranted to confirm these results.
Source: Neurocritical Care - December 13, 2021 Category: Neurology Source Type: research

The Clinical Usefulness of Targeted Temperature Management in Acute Ischemic Stroke with Malignant Trait After Endovascular Thrombectomy
ConclusionsOur data suggest that TTM attenuates impending hemorrhagic transformation and leads to favorable clinical outcomes in EVT patients with malignant trait.
Source: Neurocritical Care - August 17, 2020 Category: Neurology Source Type: research

Teleneurocritical Care for Patients with Large Vessel Occlusive Ischemic Stroke Treated by Thrombectomy
ConclusionsTeleneurocritical care allows for equivalent favorable functional outcomes compared with in-person neurocritical care for patients with acute large vessel ischemic stroke receiving thrombectomy. The standardized protocols used by TNCC in this study, specifically the comprehensive 24/7 treatment of patients in the intensive care unit for the length of their stay, may be relevant for other health systems with limited in-person resources; however, additional study is required.
Source: Neurocritical Care - November 2, 2022 Category: Neurology Source Type: research

Vancomycin Pharmacokinetic Parameters in Patients with Hemorrhagic Stroke
Conclusions Patients with hemorrhagic stroke exhibited pharmacokinetic alterations favoring increased elimination of vancomycin when compared to predicted pharmacokinetic parameters based on population data. This may result in underexposure to vancomycin, leading to treatment failure and other medical complications.
Source: Neurocritical Care - March 4, 2016 Category: Neurology Source Type: research

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