Tag Archives: table

Salt Equivalents

As an exercise, I tried to figure out the equivalent amount of salt for 1 bullet of 23.4% (30mL) compared with the other hypertonic saline solutions.

 

23.4%:  30mL = 120 mEq Na Cl;

3%, 5%, 14.6% contain 0.51, 0.86, 2.5 mEq/mL of NaCl

3% 235 mL,

5% 140mL

14.6% 48mL

 

And came up with this table.

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XLS FILE (Old Table)

 

REVISED TABLE 05/03/2018

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PDF FILE (New Table)

DOC FILE (New Table)

XLS FILE (New Table)

References

Zakaria, Asma. Neurocritical Care Board Review. New York, NY: Demos Medical, 2014.

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Empiric treatment of selected infections in the NICU

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Reference:

O’Horo, J. and Sampathkumar, P. (2017). Infections in Neurocritical Care. Neurocritical Care.

CSF Interpretation

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CSF characteristic.docx

 

References

O’Horo, J. and Sampathkumar, P. (2017). Infections in Neurocritical Care. Neurocritical Care.

Treatment of Native Vertebral Osteomyelitis (IDSA, 2015)

Parenteral Antimicrobial Treatment of Common Microorganisms Causing Native Vertebral Osteomyelitis

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Reference:

Berbari, Elie F. et al. “2015 Infectious Diseases Society Of America (IDSA) Clinical Practice Guidelines For The Diagnosis And Treatment Of Native Vertebral Osteomyelitis In Adults”. Clinical Infectious Diseases 61.6 (2015): e26-e46. <PDF link>

 

Antibiogram (LHH-Year 2015)

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LHH Antibiogram

INTERACT 2 vs ATACH 2

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Acute hypertension after ICH is associated with larger hematoma volumes and worse outcomes. Three recent RCTs investigated if control of acute hypertension (aggressive versus moderate) would lead to decreased hematoma expansion, lower mortality and improved functional outcomes.

INTERACT Phase 2 – neutral results

INTERACT Phase 3 – equivocal; no difference in mRS but possible shift in favor of intensive group.

ATACH 2 – more definitively negative results; no benefit of Brensilver antihypertensive treatment, higher rate of renal adverse events within 7d of randomization

TAKE HOME: SBP control to 120-140mm Hg does not lead to improved outcomes compared with 140-160mm Hg, may be associated with increased risk of acute renal dysfunction.

 

Comparison of the 3 major RCTs on BP reduction in ICH:

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Reference:

Majidi, Shahram, Jose I. Suarez, and Adnan I. Qureshi. “Management Of Acute Hypertensive Response In Intracerebral Hemorrhage Patients After ATACH-2 Trial”. Neurocritical Care (2016).

Burns, J., Fisher, J. and Cervantes-Arslanian, A. (2018). Recent Advances in the Acute Management of Intracerebral Hemorrhage. Neurosurgery Clinics of North America, 29(2), pp.263-272.

DCI Prevention (Failed Interventions)

Here is a list of failed interventions (so far) for DCI prevention in subarachnoid hemorrhage.

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Table was taken from first reference listed below.  The other references listed are the source articles (RCTs) where the table was based from.

Reference

Francoeur, Charles L. and Stephan A. Mayer. “Management Of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage”. Critical Care 20.1 (2016): n. pag. Web.

van den Bergh WM, Algra A, Dorhout Mees SM, van Kooten F, Dirven CMF, van Gijn J, Vermeulen M, Rinkel GJE. Randomized controlled trial of acetylsalicylic acid in aneurysmal subarachnoid hemorrhage: the MASH Study. Stroke. 2006;37:2326–30.

Petruck KC, West M, Mohr G, Weir BK, Benoit BG, Gentilli F, Disney LB, Khan MI, Grace M, Holness RO, Karwon MS, Ford RM, Cameron S, Tucker WS, Purves GB, Miller JDR, Hunter KM, Richard MT, Durity FA, Chan R, Cleain LJ, Maroun FB, Godon A. Nimodipine treatment in poor-grade aneurysm patients. J Neurosurg. 1988;68:505–17.

Siironen J, Juvela S, Varis J, Porras M, Poussa K, Ilveskero S, Hernesniemi J, Lassila R. No effect of enoxaparin on outcome of aneurysmal subarachnoid hemorrhage: a randomized, double-blind, placebo-controlled clinical trial. J Neurosurg. 2003;99:953–9.

Tseng M-Y, Hutchinson PJ, Richards HK, Czosnyka M, Pickard JD, Erber WN, Brown S, Kirkpatrick PJ. Acute systemic erythropoietin therapy to reduce delayed ischemic deficits following aneurysmal subarachnoid hemorrhage: a Phase II randomized, double-blind, placebo-controlled trial. Clinical article. J Neurosurg. 2009;111(1):171–80.

Hasan D, Lindsay KW, Wijdicks EF, Murray GD, Brouwers PJ, Bakker WH, van Gijn J, Vermeulen M. Effect of fludrocortisone acetate in patients with subarachnoid hemorrhage. Stroke. 1989;20(9):1156–61.

Mees SMD, Rinkel GJE, Vandertop WP, Pablo AA, Lavados M, van Kooten F, Kuijsten HAJM, Boiten J, van Oostenbrugge RJ, Salman RA-S, van den Bergh WM. Magnesium for aneurysmal subarachnoid haemorrhage (MASH-2): a randomised placebo-controlled trial. Lancet. 2012;380(9836):44–9.

Gomis P, Graftieaux JP, Sercombe R, Hettler D, Scherpereel B, Rousseaux P. Randomized, double-blind, placebo-controlled, pilot trial of high-dose methylprednisolone in aneurysmal subarachnoid hemorrhage. J Neurosurg. 2010;112(3):681–8.

Haley EC, Kassell NF, Torner JC. A randomized controlled trial of high-dose intravenous nicardipine in aneurysmal subarachnoid hemorrhage. A report of the Cooperative Aneurysm Study. J Neurosurg. 1993;78(4):537–47.

Zwienenberg-Lee M, Hartman J, Rudisill N, Madden LK, Smith K, Eskridge J, Newell D, Verweij B, Bullock MR, Baker A, Coplin W, Mericle R, Dai J, Rocke D, Muizelaar JP. Effect of prophylactic transluminal balloon angioplasty on cerebral vasospasm and outcome in patients with fisher grade IIi subarachnoid hemorrhage: Results of a phase II multicenter, randomized, clinical trial. Stroke. 2008;39:1759–65.

Lennihan L, Mayer SA, Fink ME, Beckford A, Paik MC, Zhang H, Wu YC, Klebanoff LM, Raps EC, Solomon RA. Effect of hypervolemic therapy on cerebral blood flow after subarachnoid hemorrhage: a randomized controlled trial. Stroke. 2000;31:383–91.

Kirkpatrick PJ, Turner CL, Smith C, Hutchinson PJ, Murray GD. Simvastatin in aneurysmal subarachnoid haemorrhage (STASH): a multicentre randomised phase 3 trial. Lancet Neurol. 2014;13(7):666–75.