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Time is Brain - Preclinical Emergency Care for Acute Ischemic Stroke
Anasthesiol Intensivmed Notfallmed Schmerzther. 2021 Dec;56(11-12):746-759. doi: 10.1055/a-1330-5239. Epub 2021 Nov 24.ABSTRACTStroke is one of the most common neurological emergencies and requires rapid detection and treatment (time is brain). There is still insufficient knowledge about stroke warning signs. It is therefore of crucial importance that trained personnel in the preclinical setting recognize the relevant warning symptoms and collect the necessary information to quickly refer the patient to the appropriate additional care structure. For this purpose, training of the emergency medical services (EMS) and the cor...
Source: Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS - November 25, 2021 Category: Intensive Care Authors: Leona M öller Lars Timmermann Anja Gerstner Source Type: research

Thromboembolic disease in COVID-19 patients: A brief narrative review
AbstractCorona virus 2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. Incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease and is seen in a multitude of organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and over production of proinflammatory cytokines mimicking a “cytokine storm” which leads to multiorgan failure. This brief narrative review highlights the pathophysiolo...
Source: Journal of Intensive Care - September 13, 2020 Category: Intensive Care Source Type: research

Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU.
Conclusion: FFA in CSF may serve as an independent prognostic biomarker for assessing the prognosis of acute ischemic stroke and the clinical outcome. It might be a useful biomarker for early detection of high-risk patients for poor outcome and hence more aggressive treatment. PMID: 32724675 [PubMed]
Source: Critical Care Research and Practice - July 31, 2020 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Tenecteplase: Thrombolytic of Choice in Stroke? Tenecteplase: Thrombolytic of Choice in Stroke?
The EXTEND-IA TNK trial suggesting better outcomes with tenecteplase than alteplase in the treatment of acute ischemic stroke has now been published in the New England Journal of Medicine.Medscape Medical News
Source: Medscape Critical Care Headlines - April 26, 2018 Category: Intensive Care Tags: Neurology & Neurosurgery News Source Type: news

Extracorporeal Membrane Oxygenation Management
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique when patients require pulmonary and/or cardiac support for days to weeks for recovery, bridge to decision, or transplantation. Due to complications associated with ECMO, it is best to stay on ECMO as little time as necessary. Foremost is weaning from ECMO, but the post-ECMO period recapitulates the entire field of critical care. Identified issues include (1) potential for systemic inflammatory response syndrome post-decannulation; (2) post-ECMO complications, such as deep vein thrombosis, wounds, renal failure, and stroke; (3) delirium; (4) posttraumatic...
Source: Critical Care Clinics - September 6, 2017 Category: Intensive Care Authors: Joseph B. Zwischenberger, Harrison T. Pitcher Source Type: research

Betrixaban in Acutely Ill Bests Enoxaparin Against Strokes: APEX Betrixaban in Acutely Ill Bests Enoxaparin Against Strokes: APEX
The finding in patients hospitalized for acute illness was said to be"a wake-up message" that even those admitted for ischemic stroke or heart failure are at special risk for thrombosis."Heartwire from Medscape
Source: Medscape Critical Care Headlines - November 29, 2016 Category: Intensive Care Tags: Cardiology News Source Type: news

Nonvitamin K antagonist oral anticoagulant activity: challenges in measurement and reversal
Four nonvitamin K antagonist oral anticoagulants (NOACs) are approved for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of venous thromboembolism. These includ...
Source: Critical Care - September 23, 2016 Category: Intensive Care Authors: Karen S. Brown, Hamim Zahir, Michael A. Grosso, Hans J. Lanz, Michele F. Mercuri and Jerrold H. Levy Source Type: research

Arrive: A retrospective registry of Indian patients with venous thromboembolism
Conclusion: Acute DVT alone was responsible for the substantial burden of VTE in Indian patients. Bleeding was not the limiting factor for anticoagulant treatment in most patients.
Source: Indian Journal of Critical Care Medicine - March 8, 2016 Category: Intensive Care Authors: Dhanesh R KamerkarM Joseph JohnSanjay C DesaiLiesel C DsilvaSadhna J Joglekar Source Type: research

Cerebral venous thrombosis presenting with intracerebral hemorrhage in a patient with paroxysmal nocturnal hemoglobinuria
Gentle Sunder Shrestha, Bishesh Sharma Poudyal, Gopal Sedain, Khandokar Imran Mahmud, Niranja AcharyaIndian Journal of Critical Care Medicine 2016 20(2):117-119Cerebral venous thrombosis (CVT) is an uncommon cause of stroke. Paroxysmal nocturnal hemoglobinuria (PNH) is a rare type of hemolytic anemia, frequently associated with thrombophilia. PNH may rarely present with CVT. Approximately, one-third of the patients with CVT develop cerebral hemorrhage. Here, we present a rare combination of CVT presenting with intracerebral hemorrhage in a patient with PNH. High index of suspicion is needed to avoid misdiagnosis. Patient w...
Source: Indian Journal of Critical Care Medicine - February 8, 2016 Category: Intensive Care Authors: Gentle Sunder ShresthaBishesh Sharma PoudyalGopal SedainKhandokar Imran MahmudNiranja Acharya Source Type: research

Management of Atrial Fibrillation
Atrial fibrillation remains the most prevalent cardiac arrhythmia, and its incidence is increasing as the population ages. Common conditions associated with an increased incidence include advanced age, hypertension, heart failure, and valvular heart disease. Patients with atrial fibrillation may complain of palpitations, fatigue, and decreased exercise tolerance or may be completely asymptomatic. Options for treating patients who experience atrial fibrillation include rate-controlling drugs such as digoxin, β-blockers, and calcium channel blockers or a rhythm-controlling strategy with agents such as sodium channel blo...
Source: Journal of Intensive Care Medicine - October 29, 2015 Category: Intensive Care Authors: Zamani, P., Verdino, R. J. Tags: Analytic Reviews Source Type: research

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