Blogs

RN SICU & Neuroscience Critical Care (Dartmouth Health)

By Amber Welch posted 04-11-2023
Title: RN SICU & Neuroscience Critical Care Company: Dartmouth Health Department: Surgical & Neuro Critical Care Units Position: Full Time Region: Lebanon, NH Description: Registered Nurses SICU and Neuroscience Critical Care with 20K loan repayment Get Back To The Nursing You Love: #nursesloveithere This is a brand-new model at Dartmouth Health for the experienced nurse to diversify their skills and work in both the Surgical & Neuro critical care units. You will have the opportunity to maintain your professional edge, challenge your abilities AND gain new clinical skills in ...

Neurointensivist (NYU Langone Medical Center)

By Amber Welch posted 04-07-2023
Title: Neurointensivist Company: NYU Langone Medical Center Department: Bellevue Hospital Position: Neurointensivist Description: The neurocritical care team at Bellevue Hospital, which is affiliated with NYU Langone Medical Center, is expanding! Bellevue Hospital is a Level 1 Trauma Center and Comprehensive Stroke Center that receives referrals from hospitals throughout NYC. The unit is staffed with Neuro ICU APPs and will have a Neuro ICU fellow as of July 2025. We are looking for two new CLINICAL neurointensivists to join our team: 11 weeks Neuro ICU service (with consult coverage nights/weekends, 11 weeks ...

Neurocritical Care PA/NP (Hackensack University Medical Center)

By Amber Welch posted 04-03-2023
Title: Neurocritical Care PA/NP Company: Hackensack University Medical Center Department: Neurology Expertise: PA-C or ACNP Region: New Jersey Description: Neurocritical Care Physician Assistant or Nurse Practitioner The neurocritical care program is recruiting for a Nurse Practitioner or Physician Assistant. Hackensack University Medical Center is a 781-bed non-profit, tertiary research and academic medical center located in Hackensack, New Jersey, servicing northern New Jersey and the New York City Metropolitan area. The Physician Assistant or Acute Care Nurse Practitioner assists, monitors, ...

Neurocritical Care NP or PA (Atlantic Health System)

By Amber Welch posted 03-31-2023
Title: Neurocritical Care (NP or PA) Company: Atlantic Health System Department: Neurocritical Care Position: Full-Time and Per-Diem Expertise: Neurocritical Care Region: New Jersey Description: Atlantic Health System (AHS), one of the largest non-profit healthcare networks in New Jersey, is seeking Neurocritical Care Advanced Practice Clinicians (NP or PA) for Full-Time and Per-Diem opportunities at multiple locations in Northern New Jersey, including the Atlantic Neuroscience Institute at Overlook Medical Center and Morristown Medical Center’s Luciano Family Trauma and Acute ...

Neurocritical Care Pharmacist - New Orleans (Ochsner Medical Center)

By Amber Welch posted 03-30-2023
Title: Neurocritical Care Pharmacist (New Orleans) Company: Ochsner Medical Center (New Orleans) Position: Neurocritical Care Pharmacist - day shift Description: This job assumes responsibility for the medication management of assigned patients; monitors and evaluates medication therapy for appropriateness based on the patient’s health status, institutional criteria /guidelines, and cost efficient measures including medication reconciliation, medication monitoring and patient education; remains integrally involved in the education of Pharmacy and Medical Residents and provides education to health care providers as ...

Keep Your Ears Open for the Upcoming Relaunch of the Neurocritical Care Society Podcast Series

By Currents Editor posted 03-24-2023
Written By: Lauren Koffman DO, MS For those listeners that have been waiting for new podcasts to be released—the time has come! The NCS Podcast Series is excited to announce a relaunch of the series, led by Nicholas Morris. Fawaz Al-Mufti has passed the torch along, and while you will still hear some familiar voices, there will be several new rotating series as well. For those that enjoyed hearing authors’ insights into trials and publications, you will still be able to enjoy these episodes, in addition to a variety of other topics. A new series will include “Hot Topics” in neurocritical care—maybe you won’t need to wait for the next annual meeting to ...

APP Neurocritical Care, NP or PA (UT Health San Antonio)

By Amber Welch posted 03-21-2023
Title: APP Neurocritical Care, NP or PA Company: UT Health San Antonio Department: Neurosurgery Departme, Neurocritical Care Division Position: APP (NP or PA) Expertise: Critical care experience recommended Region: South Texas Description: We seeking a motivated APP with interest in Neurocritical care to join our team. University Hospital is a 18 bed, level 1 trauma, comprehensive stroke and academic medical center covering San Antonio + referral center for rest of South Texas. Our team consists of 5 neurointensivists, 5 current APPs, dedicated neurocritical care fellows, and various ...

Estimating Left Ventricular Function With Bedside Echocardiography in a Stroke Patient

By Currents Editor posted 03-16-2023
Bryan Boling, DNP, AGACNP David Bacon, MD Case Details A 67-year-old man presented to the Emergency Department with left-sided weakness and slurred speech. A CT head showed no acute abnormalities, however, a CT angiogram showed stenosis of the M2 segment of the right MCA without occlusion. Acute dyspnea prompted a CT scan of his chest to assess for possible pulmonary embolism (PE). No PE was noted, but a large left ventricular thrombus was identified. He was outside the window for tPA and thrombectomy was deferred given the lack of large vessel occlusion. His wife reported that he does not go to the doctor, and was unaware of any ...

Don’t Be Afraid of the Dark: Neurocritical Care Pharmacy at Night

By Currents Editor posted 03-16-2023
Written by: Brittny Medenwald, PharmD, BCCCP (pictured left) Critical Care Pharmacist, University of Tennessee Medical Center Written by: Jessie Lipstreuer, PharmD (pictured right) Emergency Medicine Clinical Pharmacist, University of Tennessee Medical Center Healthcare workers face unique challenges during evening and overnight hours: an abundance of unplanned intensive care unit (ICU) admissions, unforeseen patient decompensation, and critical treatment decisions. 1 The majority of overnight neurocritical care (NCC) teams consist of one or two providers, often a resident or advanced practice provider. These providers have fewer resources, ...

Temperature Changes in Poor-Grade Aneurysmal Subarachnoid Hemorrhage: Relation to Injury Pattern, Intracranial Pressure Dynamics, Cerebral Energy Metabolism, and Clinical Outcome

By Currents Editor posted 03-16-2023
Published: 15 March 2023 By: Teodor Svedung Wettervik, Anders Hånell, Elisabeth Ronne-Engström, Anders Lewén & Per Enblad Abstract Background The aim was to study the course of body temperature in the acute phase of poor-grade aneurysmal subarachnoid hemorrhage (aSAH) in relation to the primary brain injury, cerebral physiology, and clinical outcome. Methods In this observational study, 166 patients with aSAH treated at the neurosurgery department at Uppsala University Hospital in Sweden between 2008 and2018 with temperature, intracranial pressure (ICP), and microdialysis (MD) monitoring were included. The first 10 days were divided into ...

Accuracy of Manual Intracranial Pressure Recording Compared to a Computerized High-Resolution System: A CENTER-TBI Analysis

By Currents Editor posted 03-16-2023
Published: 15 March 2023 By: Tommaso Zoerle, Tatiana Birg, Marco Carbonara, Peter Smielewski, Michal M. Placek, Elisa R. Zanier, Cecilia A. I. Åkerlund, Fabrizio Ortolano, Nino Stocchetti & CENTER-TBI High Resolution ICU Sub-Study Participants and Investigators Abstract Background Monitoring intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is crucial in the management of the patient with severe traumatic brain injury (TBI). In several institutions ICP and CPP are summarized hourly and entered manually on bedside charts; these data have been used in large observational and interventional trials. However, ICP and CPP may change ...

Comparison of Cerebral Autoregulation Above and Below the Tentorium of the Cerebellum In Neurosurgical Patients with Transtentorial ICP Gradient

By Currents Editor posted 03-16-2023
Published: 08 March 2023 By: Andrey Oshorov, Andrey Gavrjushin, Ivan Savin, Evgenia Alexandrova & Denis Bragin Abstract Introduction Cerebral autoregulation is an essential mechanism for maintaining cerebral blood flow stability. The phenomenon of transtentorial intracranial pressure (ICP) gradient after neurosurgical operations, complicated by edema and intracranial hypertension in the posterior fossa, has been described in clinical practice but is still underinvestigated. The aim of the study was to compare autoregulation coefficients (i.e., pressure reactivity index [PRx]) in two compartments (infratentorial and supratentorial) during the ...

Invasive Neuromonitoring Modalities in the Pediatric Population

By Currents Editor posted 03-16-2023
Published: 08 March 2023 By: Shih-Shan Lang, Raphia Rahman, Nankee Kumar, Alexander Tucker, Tracy M. Flanders, Matthew Kirschen & Jimmy W. Huh Abstract Invasive neuromonitoring has become an important part of pediatric neurocritical care, as neuromonitoring devices provide objective data that can guide patient management in real time. New modalities continue to emerge, allowing clinicians to integrate data that reflect different aspects of cerebral function to optimize patient management. Currently, available common invasive neuromonitoring devices that have been studied in the pediatric population include the intracranial pressure monitor, brain ...

Associated Risk Factors and Impact in Clinical Outcomes of Multiorgan Failure in Patients with TBI

By Currents Editor posted 03-16-2023
Published: 03 March 2023 By: Jesús Abelardo Barea-Mendoza, Mario Chico-Fernández, Lluís Serviá-Goixart, Manuel Quintana-Díaz, Iker García-Sáez, María Ángeles Ballesteros-Sanz, Alberto Iglesias-Santiago, Ismael Molina-Díaz, Javier González-Robledo, Ana Fernández-Cuervo, Jon Pérez-Bárcena, Juan Antonio Llompart-Pou on behalf of the Neurointensive Care and Trauma Working Group of the Spanish Society of Intensive Care Medicine (SEMICYUC) Abstract Background Individual extracerebral organ dysfunction is common after severe traumatic brain injury (TBI) and impacts outcomes. However, multiorgan failure (MOF) has received less attention in patients with ...

Critical Closing Pressure and Cerebrovascular Resistance Responses to Intracranial Pressure Variations in Neurocritical Patients

By Currents Editor posted 03-16-2023
Published: 03 March 2023 By: Sérgio Brasil, Ricardo de Carvalho Nogueira, Ângela Salomão Macedo Salinet, Márcia Harumy Yoshikawa, Manoel Jacobsen Teixeira, Wellingson Paiva, Luiz Marcelo Sá Malbouisson, Edson Bor-Seng-Shu & Ronney B. Panerai Abstract Background Critical closing pressure (CrCP) and resistance-area product (RAP) have been conceived as compasses to optimize cerebral perfusion pressure (CPP) and monitor cerebrovascular resistance, respectively. However, for patients with acute brain injury (ABI), the impact of intracranial pressure (ICP) variability on these variables is poorly understood. The present study evaluates the effects ...

Clinical Scoring and Ultrasound-Based Diaphragm Assessment in Predicting Extubation Failure in Neurointensive Care Unit: A Single-Center Observational Study

By Currents Editor posted 03-16-2023
Published: 01 March 2023 By: Divya Hirolli, Bharath Srinivasaiah, Radhakrishnan Muthuchellappan & Dhritiman Chakrabarti Abstract Background Patients in the neurointensive care unit (NICU) fail extubation despite successful weaning from mechanical ventilation. Parameters currently used in the general intensive care unit do not accurately predict extubation success in the NICU. In this study, peak cough expiratory flow rate, ultrasound-based diaphragm function assessment, and comprehensive clinical scoring systems were measured to determine whether these new variables, in isolation or combination, could predict extubation failure successfully ...

Liberation from Mechanical Ventilation and Tracheostomy Practice in Traumatic Brain Injury

By Currents Editor posted 03-16-2023
Published: 01 March 2023 By: Alejandro A. Rabinstein, Raphael Cinotti & Julian Bösel Abstract Liberating patients with severe traumatic brain injury (TBI) from mechanical ventilation is often a challenging task. These patients frequently require prolonged ventilation and have persistent alterations in the level and content of consciousness. Questions about their ability to protect their airway are common. Pulmonary complications and copious respiratory secretions are also very prevalent. Thus, it is hardly surprising that rates of extubation failure are high. This is a major problem because extubation failure is associated with a host of poor ...

Cerebral Autoregulation is Influenced by Carbon Dioxide Levels in Anoxic Brain Injury

By Currents Editor posted 03-16-2023
Published: 28 February 2023 By: Ilaria Alice Crippa, Federica Zama Cavicchi & Fabio Silvio Taccone Post cardiac arrest (CA) syndrome is a severe condition associated with high mortality and significant long-term disabilities among survivors, mainly because of brain injury. Whether alterations in brain hemodynamics after the return of spontaneous circulation significantly contribute to this injury remains controversial. Pressure cerebral autoregulation (CaR) is an intrinsic cerebral arteriolar homeostatic mechanism that regulates cerebral blood flow (CBF) during fluctuations in cerebral perfusion pressure (CPP) by responding with vasoconstriction ...

Association Between Admission Ionized Calcium Level and Neurological Outcome of Patients with Isolated Severe Traumatic Brain Injury: A Retrospective Cohort Study

By Currents Editor posted 03-16-2023
Published: 28 February 2023 By: Karawan Badarni, Noi Harush, Elias Andrawus, Hany Bahouth, Yaron Bar-Lavie, Aeyal Raz, Michael Roimi & Danny Epstein Abstract Background Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Pathophysiological processes following initial insult are complex and not fully understood. Ionized calcium (Ca ++ ) is an essential cofactor in the coagulation cascade and platelet aggregation, and hypocalcemia may contribute to the progression of intracranial bleeding. On the other hand, Ca ++ is an important mediator of cell damage after TBI and cellular hypocalcemia may have a neuroprotective ...

Delayed Diffusion Restriction of Wallerian Degeneration

By Currents Editor posted 03-16-2023
Published: 24 February 2023 By: Daniel J. Zhou, Daryl R. Gress & Maximiliano A. Hawkes Wallerian degeneration (WD) is the anterograde degeneration of axons following a proximal neuronal injury [ 1 ]. In the brain, WD has been described as commonly affecting the corticospinal tract after various insults [ 2 , 3 ]. Diffusion-weighted imaging (DWI) and diffusion tensor imaging sequences on magnetic resonance imaging (MRI) can precisely detect WD from the altered water content of affected tracts days to months after the initial insult [ 4 , 5 , 6 ]. Its behavior on apparent diffusion coefficient (ADC) is variable [ 7 ]. We describe the unique case ...