RISS 학술연구정보서비스

검색
다국어 입력

http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.

변환된 중국어를 복사하여 사용하시면 됩니다.

예시)
  • 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
  • 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
닫기
    인기검색어 순위 펼치기

    RISS 인기검색어

      검색결과 좁혀 보기

      선택해제
      • 좁혀본 항목 보기순서

        • 원문유무
        • 등재정보
        • 학술지명
        • 주제분류
        • 발행연도
          펼치기
        • 작성언어
        • 저자
          펼치기

      오늘 본 자료

      • 오늘 본 자료가 없습니다.
      더보기
      • 무료
      • 기관 내 무료
      • 유료
      • KCI등재후보
      • KCI등재

        Treatment of patients with severe traumatic brain injury: a 7-year single institution experience

        Corrado P. Marini,Patrizio Petrone,John McNelis,Erin Lewis,Anna Liveris,Michael F. Stiefel 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Background: This study was designed to compare the efficacy of multimodality monitoring and goal-directed therapy protocol (MM&GDTP), in patients with Glasgow Coma Scale (GCS) scores ≤8 with the conventional intracranial pressure (ICP)-cerebral perfusion pressure (CPP) treatment. Methods: The study was divided into two time periods, a 2-year historic period in which severe traumatic brain injury (sTBI) patients were treated with an ICP-CPP targeted strategy and a 5-year intervention period during which MM&GDTP was utilized. Patients with unsurvivable brain injuries were excluded. Variables of interest included mechanism of injury, age, sex, hemodynamics, GCS score, abbreviated injury score–head (AIS-H), Marshall Class, injury severity score, decompressive craniectomy, ventilator/intensive care unit days, length of stay, predicted mortality by corticosteroid randomization after significant head injury model, functional outcome, and mortality. Results: The study group comprised 810 sTBI patients, aged 14–93 years, admitted during a 7-year period; of these patients, 67 and 99 AIS-H≥4 and Marshall Class ≥III were included in control and intervention groups, respectively. The control group was treated with an ICP-CPP targeted approach, while the intervention group with an MM&GDTP. At presentation and after resuscitation, patients in the intervention group required a higher CPP to reach the endpoints of therapy. The MM&GDTP decreased mortality from 34.3% to 23.2%, yielding a 32.3% improvement in overall survival and improved functional outcome as measured by Glasgow Outcome Scale >3 (MM&GDTP vs. ICP-CPP: 50/99 vs. 15/67, P=0.003). Conclusion: Institution of MM&GDTP targeted to threshold-defined values improves functional outcomes and may reduce mortality among patients with sTBI compared to that of patients receiving an ICP-CPP–based treatment.

      • KCI등재

        Contribution of pupillary light reflex assessment to Glasgow Coma Scale for prognostication in patients with traumatic brain injury

        Amna A. Butt,Folefac D. Atem,Sonja E. Stutzman,Venkatesh Aiyagari,Aardhra M. Venkatachalam,DaiWai M. Olson,Shoji Yokobori 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Background: Glasgow Coma Scale (GCS) and the pupillary light reflex (PLR) are important prognostic tools for traumatic brain injury (TBI). This study compared the predictability of GCS, GCS plus manual PLR (GCS-P), GCS plus Neurological Pupil index (GCS-NPi), and average NPi (avgNPi) in predicting discharge outcome in patients diagnosed with TBI. Methods: Data were obtained from a multicenter prospective registry that included 175 subjects with TBI. A nonlinear mixed model (NLMIXED) approach was used to determine which of the following independent variables (GCS, GCS-P, GCS-NPi, and avgNPi) is a better predictor of modified Rankin Scale (mRS) at discharge by fitting four predictive models for comparison. Results: The NLMIXED model for longitudinal data determined that GCS, GCS-P, GCS-NPi, and avgNPi were all significant predictors of mRS at discharge (P<0.001). Age was a significant predictor of the discharge mRS (P<0.001). There was a strong significant correlation between the four predicting variables (P<0.05). The maximum likelihood estimation (MLE) of GCS was –0.17 (P<0.001), MLE of GCS-P was –0.17 (P<0.001), MLE of GCS-NPi was –0.17 (P<0.001), and the MLE of avgNPi was –0.39 (P<0.001). Conclusion: Our findings suggest that any of the four variables (GCS, GCS-P, GCS-NPi, and avgNPi) could be used as a potential predictor of discharge mRS in a patient with TBI. This warrants future investigations to explore the combination of pupillary reactivity scores and NPi with GCS for prognostication in patients with TBI.

      • KCI등재

        Hiccups in neurocritical care

        Vanitha Rajagopalan,Deep Sengupta,Keshav Goyal,Surya Kumar Dube,Ashish Bindra,Shweta Kedia 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. The evidence to support or declare any intervention as harmful is scarce. In this review, we have presented the pathophysiology and workup, and a stepwise management protocol for intractable hiccups.

      • KCI등재

        Role of continuous hypertonic saline in acute ischemic infarcts: a systematic literature review

        Arunit J. S. Chugh,Marquis Maynard,Kerrin Sunshine,Berje H. Shammassian,Adam Sauer,Kolade Odetoyinbo,S. Alan Hoffer 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Continuous hypertonic saline for hemispheric ischemic infarcts has been routinely used in neurocritical centers for the management of malignant cerebral edema. However, the data supporting its use are extremely limited. We present a systematic literature review that highlights five studies (one randomized control trial and four retrospective cohort) where the effects of continuous hypertonic saline were studied in patients with acute ischemic infarcts. Collectively, there is a lack of substantial evidence supporting its use. Also, this review emphasizes significant study flaws that make the conclusions largely nongeneralizable. Although the reported studies demonstrate improvement in control of intracranial pressure, there are no significant differences in neurological or functional outcomes or overall mortality.

      • KCI등재

        Utility of medical simulation in neurovascular critical care education

        Sandra Mass-Ramírez,Hernán Vergara-Burgos,Carmen Sierra-Ochoa,Ivan David Lozada-Martinez,Luis Rafael Moscote-Salazar,Tariq Janjua,Md Moshiur Rahman,Sabrina Rahman,Yelson Alejandro Picón-Jaimes 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Simulation has shown good results in medical scenarios in which the patient’s problem can be solved by following protocols previously established in clinical practice guidelines. Therefore, the implementation of simulation programs in neurocritical care improves the outcomes of patients at clinical centers because a properly trained professional will be able to provide the most effective care in the shortest time possible, safeguarding the patient’s life. Some learning and simulation models that can be included in medical education to improve neurocritical vascular care include task trainers, full-body mannequins, standardized patients, and computer-based simulation. Specifically, medical simulation in academic training programs in health sciences has a great impact on the development of specific skills, which could potentially reduce medical-legal and economic issues, improve care, and result in the management of clinical events. Simulation is established as an essential educational tool, allowing the instruction of knowledge from an interactive perspective and offering a broader vision when it comes to medical practice. The objective of this article is to present evidence related to the usefulness and impact of medical simulation in neurovascular critical care education.

      • KCI등재

        Paralytic rabies mimicking Guillain-Barré syndrome: the dilemma still prevails

        Rohini M. Surve,Hima S. Pendharkar,Sonia Bansal 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Background: Paralytic rabies lacks the hallmark signs of rabies at presentation and is often misdiagnosed as Guillain-Barré Syndrome (GBS). Sensitive antemortem diagnostic criteria for rabies is lacking, and the diagnosis is confirmed posthumously by demonstrating Negri bodies on brain biopsy. Antemortem brain and spine magnetic resonance imaging findings have recently been reported for paralytic rabies. Case Report: We report a case of paralytic rabies in a young boy who was initially misdiagnosed with GBS. In this case, brain and spine magnetic resonance imaging (MRI) findings pointed towards paralytic rabies, which was confirmed by the presence of anti-rabies antibodies in the serum and cerebrospinal fluid analysis, and posthumously by Negri bodies on brain biopsy. Conclusion: In patients with GBS, paralytic rabies should be considered as an alternative diagnosis, especially in regions where rabies is endemic, and early MRI of the brain and spine should be considered for the antemortem diagnosis of paralytic rabies.

      • KCI등재

        Refractory brainstem encephalitis mimicking progressive cerebral infarction: infliximab and methotrexate as a salvage immunotherapy

        안성호,Roh Jieun,Woo Kyoung-Nam,김현성,박민규,박경필,백승국,신진홍 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Background: Brainstem encephalitis is a rare, severe, and potentially life-threatening inflammation of the central nervous system, exhibiting various treatment responses and outcomes owing to multiple etiologies. Case Report: We describe the favorable outcome of salvage immunotherapy using a combination of infliximab and methotrexate in a 62-year-old woman with refractory brainstem encephalitis. The patient was initially presumed to be at a subacute stage of medullary infarction but showed progressively worsening conditions involving cervical myelopathy, despite having completed the schedule of subsequent immunotherapy with intravenous methylprednisolone, immunoglobulin, and rituximab. After completion of four sessions of weekly rituximab injection, she was treated with 5 mg/kg of infliximab, scheduled at 0, 2, and 6 weeks, along with methotrexate (weekly 12.5 mg). After completion of infliximab injection and maintenance with methotrexate treatment, she showed an improving course of quadriplegia. Conclusion: This case report provides evidence for the potential efficacy of infliximab with methotrexate in cases of refractory brainstem encephalitis.

      • KCI등재

        Pneumococcal meningitis complicated by otomastoiditis and pneumocephalus confounding an acute ischemic stroke diagnosis

        Matea Malinovic,John Peterson,Felecia Lee 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1

        Background: Approximately one-fourth of admissions to stroke centers are diagnosed with non-stroke conditions or stroke mimics. Differentiating between these diagnoses and acute ischemic stroke is an important and time-sensitive task. The decision of whether or not to administer thrombolytic therapy is also a critical component, and its safety has been studied numerous times. Case Report: This case presents a patient with pneumococcal meningitis initially diagnosed as an acute ischemic stroke treated with thrombolytic therapy before further imaging. Conclusion: Many stroke mimics such as migraines, infections, and seizures exist. Time is of the essence for the treatment of an acute ischemic stroke. The safety profile of tissue plasminogen activator has been studied numerous times in stroke mimics and shown to be relatively safe indicating if the patient has no contraindications for stroke intervention, treatment of stroke should not be extensively delayed to rule out stroke confounders.

      • KCI등재

        Urgent decompression of tension pneumomediastinum in a patient to relieve elevated intracranial pressure: a case report

        Ahmed Khalid Mohamed,Chan-Leveno Teresa V.,Lussier Bethany L. 대한신경집중치료학회 2022 대한신경집중치료학회지 Vol.15 No.1

        Background: Timely recognition and intervention for venous outflow obstruction due to intrathoracic pathology are critical for controlling elevated intracranial pressure.Case Report: A 26-year-old man with pectus excavatum and a posterior fossa tumor requiring biopsy, decompression, and cerebrospinal fluid diversion developed pneumomediastinum following intubation with tension physiology and progressive elevation of intracranial pressure. Emergent tracheostomy was performed to decompress intrathoracic pressure, augment venous return, and ultimately expedite the patient’s definitive cancer therapy. Conclusion: Recognition of the mediastinal pathology leading to venous obstruction may be required for the management of malignant intracranial hypertension. Tracheostomy may be a means to decompress mediastinal pressure and augment venous outflow in rare cases of pneumomediastinum with tension physiology.

      연관 검색어 추천

      이 검색어로 많이 본 자료

      활용도 높은 자료

      해외이동버튼