1 online resource (xi, 457 pages) : : digital, PDF file(s).

Second edition.

Title from publisher's bibliographic system (viewed on 24 Jul 2019).. - Cover -- Half-title -- Title page -- Copyright information -- Contents -- List of Contributors -- Preface -- Chapter 1 The Neurological Assessment of the Critically Ill Patient -- General Approach to the Neurological Assessment -- Sedation -- Delirium -- Stupor and Coma -- Assessing a Patient with Impaired Consciousness -- 1. Initial Stabilization -- 2. Initial Assessment -- 3. Focused Neurological Exam -- GCS and FOUR Score -- Respiratory Patterns -- The Eye Exam -- Brainstem Reflexes -- Pupillary Responses -- Eyelid and Corneal Reflexes -- Oculocephalic Reflex -- Oculovestibular (Caloric) Reflex -- Gag and Cough Reflexes -- Motor Responses -- Assessing Neuromuscular Complications -- Conclusion -- References -- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit -- Normal Physiology of Cerebral Blood Flow -- Autoregulation -- Relationship Between CBF and PaCO2 -- Cerebral Ischemia -- CBF in Acute Ischemic Stroke -- CBF in Intracerebral Hemorrhage -- CBF in Subarachnoid Hemorrhage -- CBF in Traumatic Brain Injury -- Techniques for CBF Measurement -- Fick Principle -- Central Volume Principle -- Thermal Diffusion -- Transcranial Doppler (TCD) -- Near-infrared Spectroscopy (NIRS) -- References -- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit -- References -- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications -- Introduction -- Mechanism of Neuroprotection -- Approach to Hypothermia -- Clinical Applications of Hypothermia -- Hypothermia and Cardiac Arrest -- Hypothermia and Ischemic Stroke -- Hypothermia and Intracerebral Hemorrhage -- Hypothermia and Subarachnoid Hemorrhage -- Hypothermia and Traumatic Brain Injury -- Hypothermia and Spinal Cord Injury -- Hypothermia and Status Epilepticus -- Conclusions -- References.. - Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit.. - Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit -- Sedation -- Indications for Sedation -- Sedation Assessment -- Subjective Assessment of Sedation and Agitation -- Pharmacology of Selected Sedatives -- Benzodiazepines -- Midazolam (Versed) -- Lorazepam (Ativan) -- Diazepam (Valium) -- Synergistic Sedation Regimens with Benzodiazepines -- Propofol (2,6-Diisopropyl Phenol) -- Propofol Infusion Syndrome (PRIS) -- α2-Agonists -- Dexmedetomidine (Precedex) -- Clonidine (Catapres) -- Neuroleptics -- Haloperidol (Butyrophenone) -- Droperidol (Inapsine) -- Other Sedatives -- Etomidate -- Ketamine -- Barbiturates -- Diphenhydramine (Benadryl) -- Recommendations -- Delirium -- Treatment of Delirium -- Nonpharmacologic Strategies -- Analgesia -- Pain Assessment -- Analgesic Agents -- Opiates -- Fentanyl (Sublimaze) -- Remifentanil (Ultiva) -- Morphine Sulfate -- Hydromorphone (Dilaudid) -- Oxycodone (Percocet, Percodan) -- Codeine (Empirin #2,3,4 -- Tylenol #2,3,4) -- Tramadol (Ultram) -- Narcotics with Active Metabolites -- Nonopiates -- Ketamine -- Local Anesthetics (Lidocaine, Bupivacaine, Others) -- Acetaminophen (Tylenol) -- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) -- Ketoralac (Toradol) -- Ibuprofen (Motrin) -- Selective COX-2 Inhibitors -- Drugs for Neuropathic Pain -- Gabapentin -- Neuromuscular Blockade -- Indications -- Pharmacology of Neuromuscular-Receptor Blockers -- Aminosteroidal Compounds -- Pancuronium -- Pipecuronium -- Vecuronium -- Rocuronium -- Benzylisoquinolinium Compounds -- d-Tubocurarine -- Atracurium -- Cisatracurium -- Doxacurium -- Mivacurium -- Recommendations for Monitoring Degree of Blockade -- Potential Complications of Neuromuscular Blockade Use in the ICU -- Prolonged Recovery from NMBAs -- Acute Quadriplegic Myopathy Syndrome -- Drug-Drug Interactions of NMBAs -- References.. - Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit -- Introduction -- General Airway and Ventilation Management Concerns -- Airway Management -- Indications for Intubation -- Contraindications to (Elective) Intubation -- Alternatives to Intubation -- Preparation for Intubation -- Preparation for Difficult Mask Ventilation and Difficult Airway Scenarios -- Induction Medication Issues to Consider in the Neurocritically Ill -- Intubation in the Setting of Elevated Intracranial Pressure -- Intubation in the Setting of Impaired Cerebral Perfusion -- Intubation of a Patient with an Unstable Cervical Spine -- Reducing Peri-Intubation Risk -- Neuromuscular Respiratory Failure -- Preintubation Neurological Evaluation -- Intubation -- Approach to the Difficult Airway -- Overview of Ventilation -- Effects of Hyperventilation and Hypoventilation on Brain Physiology -- Acidemic and Alkalemic Hypocarbia: Potential for Suppression of Spontaneous Hyperventilation -- Purposeful Hyperventilation to Control Elevated ICP -- Effects of Hyperoxia and Hypoxia on Brain Physiology -- Noninvasive Ventilation -- Acute Respiratory Distress Syndrome -- Airway Pressure and Intracranial Pressure -- Liberation from Mechanical Ventilation -- Ventilator Weaning -- Tracheostomy -- Long-Term Ventilation -- Summary -- References -- Chapter 7 Neuropharmacology in the Neurocritical Care Unit -- Introduction -- Sedatives -- Opioid Analgesics -- Benzodiazepines -- Propofol -- Dexmedetomidine -- Antiepileptics -- Seizure Prophylaxis -- Traumatic Brain Injury (TBI) -- Aneurysmal Subarachnoid Hemorrhage (aSAH) -- AED Therapeutic Drug Monitoring and Drug-Drug Interactions -- Fosphenytoin and Phenytoin TDM Targets -- Total Concentrations of 10-20 μg/mL -- Free (unbound) Concentrations of 1-2 μg/mL -- Fosphenytoin and Phenytoin TDM Principles.. - Fosphenytoin and Phenytoin Drug-Drug Interactions -- Phenobarbital TDM Target -- Total Concentrations of 15-40 μg/mL -- Sodium Valproate and Derivatives TDM Targets -- Free (unbound) Concentrations of 1-2 μg/mL -- Hyperosmolar Solutions -- Antishivering Agents -- Cerebral Vasospasm and Delayed Cerebral Ischemia -- Systemic Therapies -- Triple-H Therapy -- Nimodipine -- Nicardipine -- Magnesium -- Locally Administered Therapies -- Alteplase -- Nicardipine -- Verapamil -- Papaverine -- References -- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit -- Introduction -- Intracranial Pressure Monitoring -- Brain Tissue Oxygen Monitoring -- Cerebral Microdialysis -- Regional Cerebral Blood Flow Monitoring -- Jugular Bulb Saturation -- Advanced Neuroimaging as a Neuromonitor -- Clinical Algorithms for Monitoring in the Neurocritical Care Unit -- Conclusion -- References -- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit -- Continuous Electroencephalography (CEEG) in the ICU -- Detection of Nonconvulsive Seizures and Status Epilepticus -- Convulsive Status Epilepticus -- Subarachnoid Hemorrhage -- Intracerebral Hemorrhage -- Ischemic Stroke -- Traumatic Brain injury (TBI) -- Toxic Metabolic Encephalopathy -- Hypoxic-Ischemic Injury -- Duration of Monitoring -- Monitoring of Ongoing Therapy -- Ischemia Detection -- Prognosis -- Following Cardiac Arrest -- Following Other Causes of Acute Brain Injury -- What Should Be Treated? -- Other Electrophysiologic Studies in the ICU -- References -- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit -- Introduction -- Subarachnoid Hemorrhage: Detection of Vasospasm -- Technical Aspects of TCD -- Middle Cerebral Artery Vasospasm -- Anterior Cerebral Artery Vasospasm -- Internal Carotid Artery Vasospasm.. - Vertebral and Basilar Arteries Vasospasm -- Complete TCD Examination with Lindegaard Ratio Determination -- Distal Vasospasm Detection by TCD -- TCD in Traumatic Brain Injury: Intracranial Pressure and Cerebral Perfusion Pressure -- Brain Death -- Assessment of CO2 Reactivity and Pressure Autoregulation -- Acute Ischemic Stroke and Monitoring of Recanalization -- Monitoring for Emboli -- Carotid Endarterectomy and Carotid Artery Stenting -- Summary -- References -- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit -- Introduction -- What is a ''Severe'' Ischemic Stroke? -- When Should a Patient with AIS be Placed in the NCCU? -- Acute Assessment in the Emergency Room -- Vital Functions -- Relevant History -- Neurological Exam -- Grading the Deficit -- Diagnostic Tests -- Laboratory -- Imaging -- Bedside Monitoring -- Acute Treatment of Early Ischemic Stroke -- Supplementary Oxygen, Airway and Ventilation Management -- Blood Pressure -- Blood Glucose -- Anticoagulation and Antiaggregation -- Recanalization -- Decision-Making According to Guidelines, Approval and Beyond -- Intravenous Thrombolysis -- Intra-Arterial Thrombolyis, Mechanical Thrombectomy -- Peri-Interventional Care -- General Aspects of Ischemic Stroke Management in the NCCU -- Airway Management -- Ventilation -- Analgesia and Sedation -- Gastrointestinal Tract -- Fluid Status and Nutrition -- Glucose Control -- Hemoglobin Control -- Deep Vein Thrombosis Prophylaxis -- Anticoagulation -- Infectious Disease Management -- Blood Pressure Management -- Temperature Management -- Seizures -- Management of Brain Edema and Raised Intracranial Pressure -- Management of Specific Types of Ischemic Stroke -- Large Hemispheric Infarction -- Space-Occupying Cerebellar Stroke -- Basilar Occlusion -- Ischemic Stroke from Infective Endocarditis -- References.. - A significant number of critically ill neurological and neurosurgical patients are still managed in the medical or surgical ICU by non-neurointensivists, who have a hard time appreciating the delicate needs of these patients. This dynamic guide reviews current topics facing neurocritical care providers in a straight-forward, structured, and practical way. Providing clear summaries in the management of neuro critical care conditions, this text allows for accessible, highly structured, and focused protocols for the assessment, day-to-day management, and treatment of critically ill patients in various ICU settings. This comprehensive, thorough guide to the management and treatment of neurologic and neurosurgical patients, is an excellent companion for trainees preparing for the Neurovascular Boards, Neurologists, Neurosurgeons and critical care physicians, alike. Designed by leaders in their field, this thorough guide presents practical, state-of-the-art suggestions for physicians, worldwide.

Electronic books.

616.02/8

1-107-58790-5. - 1-108-61195-8