●Coagulopathy, plt < 50K, INR >1.5, or PTT >2 x control
●Mechanical ventilation for >48 hours
●h/o GI ulceration or bleeding within past year
●TBI, traumatic SCI, burn injury
●Two or more of the following minor criteria:
- ICU >1week
- occult GI bleeding x >=6 days
- glucocorticoid therapy (>250 mg hydrocortisone or equivalent)
“Stress Ulcer Prophylaxis In The Intensive Care Unit.” Uptodate.com, 2017. 30 Oct. 2017.
-consists of simultaneous administration of fast-acting sedative to induce immediate unresponsiveness and a NMBA to achieve optimal intubating conditions, with goal of attaining control of airway in critically ill patient at risk of aspiration of stomach contents.
– limits ICP elevation, preferred method for intubation of patient with elevated ICP
– presence of coma does not justify proceeding without pharmacologial agents, although patient unresponsive, laryngoscopes and intubation provoke reflexes that elevate ICP unless pre-treatment and induction agents are used.
ENLS 2017 Airway. Neurocritical Care.
Mnemonics to assess for difficult airways during intubation.
ENLS 2017, Airway.
ENLS 2017 Pharmacotherapy. Neurocritical Care Journal.
The following volumes of hypertonic solution are equip solar to 1g/Kg of mannitol:
ENLS: pharmacotherapy (2017) Neurocritical Care Journal
Kiwon Lee. NeuroICU Book.
Kiwon Lee, NeuroICU Book.