The accuracy of transcranial Doppler in excluding intracranial hypertension following acute brain injury: a multicenter prospective pilot study.

Background: Untimely diagnosis of intracranial hypertension may lead to delays in therapy and worsening of outcome. Transcranial Doppler (TCD) detects variations in cerebral blood flow velocity which may correlate with intracranial pressure (ICP). We investigated if intracranial hypertension can be accurately excluded through use of TCD.

Organizational aspects of donor procurement activity in the North Italy Transplant programme (NITp).

In Italy, organ procurement is insufficient to meet patient need. The aim of this study was to estimate the potential donor pool, quantify nonused donors, identify causes of nonretrieval, and evaluate the impact of some hospital organizational problems on organ procurement. In 1995 a questionnaire was sent to 103 intensive care units (ICUs) in 92 hospitals of the NITp area.

Retrograde cannulation of the jugular vein: erroneous positioning of the catheter in the subarachnoid space.

This report describes one complication related to retrograde positioning of a catheter in the jugular vein in a patient in a coma resulting from subarachnoid haemorrhage. The catheter was found in the cervical subarachnoid space, as confirmed by radiography with contrast medium. Attention is focused on the fact that this technique, usually performed easily and safely, may occasionally present potentially severe complications.

[Pathology requiring admission to the neurosurgical intensive care].

A patient's admission to an ICU should benefit the patient (either short or long term). Consequently patients admitted to the ICU should be only those neurological-neurosurgical ones with one or more organ failure who need immediate or prolonged therapy with adequate monitoring and technical support not available in other wards. Normally admission depends on may other factors, the most important ones seem to be medico-legal responsibilities of the possible refusal of admission even if due to clinical reasons, organizational problems such as equipment and bed availability.