Targeted Temperature Management in Cardiac Arrest with Nonshockable Rhythm

J.B. Lascarrou, H. Merdji, A. Le Gouge et el published the results of HYPERION (Hypothermia after Cardiac Arrest in Nonshockable Rhythm) trial in NEJM. WHAT Open-label, randomized, controlled trial comparing moderate therapeutic hypothermia (33°C during the first 24 hours) with targeted normothermia (37°C) in adult patients with coma(GCS <8) after resuscitation from cardiac arrest with … Read more Targeted Temperature Management in Cardiac Arrest with Nonshockable Rhythm

FDA approved First Factor Xa Inhibitor Antidote

An estimated 4 million people are taking factor Xa inhibitors, such as rivaroxaban (Xarelto, Bayer/Janssen Pharmaceuticals) and apixaban (Eliquis, Bristol-Myers Squibb). In the USA, Apixaban generated 4.9 billion dollars for the company last year. Until now, there was no approved reversal agent for these factor Xa inhibitors. In the United States alone, there were approximately … Read more FDA approved First Factor Xa Inhibitor Antidote

Delayed thrombectomy in acute stroke effective

R.G. Nogueira, A.P. Jadhav, D.C. Haussen et el published in NEJM on Nov 18,2017 trial results of delayed(6-24 hours) thrombectomy in acute stroke patients who had a mismatch between the severity of the clinical deficit and the infarct volume, conducted at 26 centers in the United States, Canada, Europe, and Australia. BACKGROUND National Institute of Neurologic Disorders and Stroke … Read more Delayed thrombectomy in acute stroke effective

Head position in acute ischemic stroke

C.S. Anderson, H. Arima and P. Lavados et el published in NEJM a new cluster randomized trial about head position in acute ischemic stroke showing no difference between head elevation and flat position for first 24 hours (HeadPost Trial). BACKGROUND Earlier animal and non randomized small human studies showed that flat position may increase the … Read more Head position in acute ischemic stroke

Guidelines for VTE prophylaxis in Neurocritical Care

Nyquist, Paul, Jichici, Draga et el recently published evidence based guidelines for prevention of venous thromboembolism in neurocritical care. Risk of venous thromboembolism is present in all hospitalized patients and specially higher in neurocritical patients due to immobility. Combination therapy with chemoprophylaxis (Unfractioned heparin, Low molecular heparin) and mechanical prophylaxis (Intermittent pneumatic compression devices) is superior … Read more Guidelines for VTE prophylaxis in Neurocritical Care

Guidelines for reversal of antithrombotics in intracranial hemorrhage

Neurocritical Care Society and Society of Critical Care Medicine just published guidelines for the reversal of antithrombotics in intracranial hemorrhage. Summary is here in this table.     Antithrombotic agent Reversal agent Vitamin K antagonists If INR more than 1.4   vitamin K 10 mg IV, plus 3- or 4-factor PCC IV (dosing based on … Read more Guidelines for reversal of antithrombotics in intracranial hemorrhage

THRACE TRIAL : Mechanical thrombectomy is better than Alteplase alone in Stroke

Bracard S et el  in recently published THRACE trial compared mechanical thrombectomy in addition to standard Alteplase for stroke. Mechanical thrombectomy in addition to standard care improved clinical outcomes (functional independence at 3 months (odds ratio 1.55, 95% CI 1.05-2.30; p=0.028). There was no difference in mortality or symptomatic intracranial hemorrhage in two groups. Common adverse … Read more THRACE TRIAL : Mechanical thrombectomy is better than Alteplase alone in Stroke

Nebulized Eucalyptus prevents Ventilator-associated PneumoniaRead more
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