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Thematic Analysis of Psychosocial Stressors and Adaptive Coping Strategies Among Informal Caregivers of Patients Surviving ICU Admission for Coma
ConclusionsIn response to substantial stressors, family caregivers of patients with SABI attempted to enact various psychological and behavioral coping strategies. They described avoidance and distraction as less helpful than other coping strategies but had difficulty engaging in alternative strategies because of their emotional distress. These findings can directly inform the development of additional resources to mitigate the long-term impact of acute psychological distress among this caregiver population.
Source: Neurocritical Care - July 31, 2023 Category: Neurology Source Type: research

Weaning Outcomes in Patients with Brain Injury
ConclusionsPatients with acute brain injury, compared with patients without brain injury, present higher odds of undergoing unplanned extubated after weaning was started, lower odds of being extubated after the first attempt, and a higher risk of reintubation.
Source: Neurocritical Care - September 1, 2022 Category: Neurology Source Type: research

Taking a Chance to Recover: Families Look Back on the Decision to Pursue Tracheostomy After Severe Acute Brain Injury
ConclusionsAfter SABI, prognostic uncertainty almost transcends the concept of choice. Families who proceeded with a tracheostomy saw it as the only option at the time. High-quality communication may mitigate the stress surrounding this high-stakes decision.
Source: Neurocritical Care - September 2, 2021 Category: Neurology Source Type: research

US Practitioner Attitudes Toward Tracheostomy Timing, Benefits, Risks, and Techniques for Severe Stroke Patients: A National Survey and National Inpatient Sample Analysis
Source: Neurocritical Care - October 22, 2020 Category: Neurology Source Type: research

Outcomes After Tracheostomy in Patients with Severe Acute Brain Injury: A Systematic Review and Meta-Analysis
ConclusionsOur findings suggest that about one in three patients with SABI who undergo tracheostomy may eventually achieve independence. Future research is needed to understand the reasons for the heterogeneity between studies and to identify those patients with promising outcomes as well as factors influencing outcome.
Source: Neurocritical Care - October 9, 2020 Category: Neurology Source Type: research

Use of a Novel Negative-Pressure Tent During Bedside Tracheostomy in COVID-19 Patients
ConclusionsIt is feasible to perform PDT on intubated COVID-19 patients using the AerosolVE negative-pressure tent. This is a promising low-cost device to decrease risk to healthcare providers during AGPs.
Source: Neurocritical Care - August 6, 2020 Category: Neurology Source Type: research

A Pilot Study of Pharyngeal Electrical Stimulation for Orally Intubated ICU Patients with Dysphagia
ConclusionAlthough limited by its small size and non-blinded design, this is the first study demonstrating the benefits of PES in ICU patients still orally intubated, thus offering a potential new method to reduce morbidity, mortality, and economic burden in a mixed ICU population. In order to further investigate and strengthen our findings, a statistically powered, randomized controlled study is recommended.
Source: Neurocritical Care - March 19, 2020 Category: Neurology Source Type: research

Predictors for Tracheostomy with External Validation of the Stroke-Related Early Tracheostomy Score (SETscore)
ConclusionsSETscore is a simple score with a moderate accuracy and with a fair AUC used to predict the need for TR after MV for IS, ICH, and SAH patients. Our study also demonstrates that early TR was associated with a lower ICU LOS and VD in our cohort. The utility of this score may be improved when including additional variables such as BMI, AA race, ICH, and positive sputum cultures.
Source: Neurocritical Care - August 30, 2018 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

Heart-Shaped Bilateral Medullary Pyramidal Infarction as a Pathognomonic Finding of Anterior Spinal Artery Occlusion
ConclusionAcute BMP infarction may present with flaccid tetraplegia mimicking neuromuscular disorders. When the infarction is recognized early, intravenous thrombolysis can be considered to reduce morbidity of this rare stroke subtype.
Source: Neurocritical Care - May 8, 2017 Category: Neurology Source Type: research

Acute Posterior Cranial Fossa Hemorrhage —Is Surgical Decompression Better than Expectant Medical Management?
ConclusionsSDC following PCFH was associated with a reduction in mortality compared to expectant MT with or without EVD insertion. A high-quality multicenter randomized control trial is required to evaluate the superiority of SDC for PCFH.
Source: Neurocritical Care - November 30, 2016 Category: Neurology Source Type: research

Patient Age and the Outcomes after Decompressive Hemicraniectomy for Stroke: A Nationwide Inpatient Sample Analysis
Conclusion In this nationwide analysis, DHC was associated with reduced mortality regardless of patient age, including among those aged greater than 70 years. However, patients aged greater than 60 years treated surgically experienced higher odds of mortality (32.4 %), discharge to institutional care (47.1 %), and a poor outcome (77.0 %) compared with younger patients.
Source: Neurocritical Care - July 11, 2016 Category: Neurology Source Type: research

Acute Posterior Cranial Fossa Hemorrhage—Is Surgical Decompression Better than Expectant Medical Management?
Conclusions SDC following PCFH was associated with a reduction in mortality compared to expectant MT with or without EVD insertion. A high-quality multicenter randomized control trial is required to evaluate the superiority of SDC for PCFH.
Source: Neurocritical Care - April 11, 2016 Category: Neurology Source Type: research

Predictors of Extubation Success in Patients with Posterior Fossa Strokes
Conclusions In posterior fossa stroke patients with a GCS ≤ 6 at the time of intubation and who remain intubated for more than 1 week, extubation is less likely to be successful, and tracheostomy should be considered.
Source: Neurocritical Care - February 17, 2016 Category: Neurology Source Type: research

The SETscore to Predict Tracheostomy Need in Cerebrovascular Neurocritical Care Patients
Conclusions Based on this monocentric study, the SETscore seems to be a valid tool to indicate prolonged NICU-LOS and VT, as well as TT need in cerebrovascular NICU patients. Confirmation of these results in larger cohorts with various settings may help to develop the SETscore as a decisive tool on primary TT early in time to avoid extubation failure.
Source: Neurocritical Care - February 2, 2016 Category: Neurology Source Type: research

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