Publications by authors named "Nicolas Ciarrocchi"

Intracranial hypertension (ICH) is a common and critical condition in neurocritical care, often requiring immediate intervention. Current methods for continuous intracranial pressure (ICP) monitoring are invasive and costly, limiting their use in resource-limited settings. This study investigates the potential of the electroencephalography (EEG) as a non-invasive alternative for ICP monitoring.

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Article Synopsis
  • Chronic subdural hematoma (cSDH) is a growing health issue among the elderly, characterized by the development of a new vascular membrane that complicates treatment.
  • The study discusses a technique called middle meningeal artery (MMA) embolization, which can treat cSDH either alone or alongside surgery, highlighting its application in a university hospital in Argentina.
  • In this study, 6 patients aged around 72.5 were treated with MMA embolization, leading to no new surgical interventions post-discharge, demonstrating the safety and efficacy of this treatment option.
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Dengue virus is an endemic virus in Argentina that, although it was initially considered to be non-neurotropic, it is currently recognized to be neuroinvasive; thus conditioning a prevalence of neurological manifestations of up to 15% among patients. Even being considered severe symptoms, there is underdiagnoses of dengue encephalitis due to its varied clinical presentation. Neurological manifestations of dengue encephalitis can range from fever and headache to altered levels of consciousness and seizures.

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The apnea test, employed for brain death assessment, aims to demonstrate the absence of respiratory drive due to hypercapnia. The tracheal oxygen insufflation apnea test mode (I-AT) involves disconnecting the patient from invasive mechanical ventilation (iMV) for approximately 8 minutes while maintaining oxygenation. This test supports the diagnosis of brain death based on a specified increase in PaCO2.

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Purpose: This study aims to describe the total EEG energy during episodes of intracranial hypertension (IH) and evaluate its potential as a classification feature for IH.

New Methods: We computed the sample correlation coefficient between intracranial pressure (ICP) and the total EEG energy. Additionally, a generalized additive model was employed to assess the relationship between arterial blood pressure (ABP), total EEG energy, and the odds of IH.

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Article Synopsis
  • This study investigates the potential of using electroencephalography (EEG) to create a real-time, noninvasive way to measure intracranial pressure (ICP) as opposed to traditional invasive methods.* -
  • Researchers conducted experiments on a porcine model of intracranial hypertension, analyzing the relationship between ICP and the slope of the EEG power spectral density, quantified by the ϕ angle.* -
  • Results show a strong correlation between the ϕ angle and ICP levels, suggesting that EEG ϕ angle could be a reliable indicator for monitoring ICP and cerebral perfusion in real time.*
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Intracranial pressure (ICP) monitoring is commonly used in the follow-up of patients in intensive care units, but only a small part of the information available in the ICP time series is exploited. One of the most important features to guide patient follow-up and treatment is intracranial compliance. We propose using permutation entropy (PE) as a method to extract non-obvious information from the ICP curve.

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Stroke is the leading cause of neurological disability in people over 40 years of age and the fourth leading cause of death in Argentina. In the last ten years, the indexed publications related to the treatment of ischemic stroke were more numerous than those of hemorrhagic stroke. The objective of this material is to provide local and updated recommendations for the management of patients with spontaneous intracerebral hemorrhage during hospitalization.

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Background: Intracerebral hemorrhage (ICH) is the second most common subtype of stroke but is associated with greater rates of disability or mortality. One of the factors of a poor prognosis is large hematoma volume. The MISTIE III trial with the aim of decreasing clot size showed that the greater the ICH reduction, the higher likelihood of lower mortality without a net increase in the proportion of patients with severe disability.

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Background: Intracranial hypertension (HI) is associated with worse neurological outcomes and higher mortality. Although there are several experimental models of HI, in this article we present a reproducible, reversible, and reliable model of intracranial hypertension, with continuous multimodal monitoring.

New Method: A reversible intracranial hypertension model in swine with multimodal monitoring including intracranial pressure, arterial blood pressure, heart rate variation, brain tissue oxygenation, and electroencephalogram is developed to understand the relationship of ICP and EEG.

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Objective: The development of the extracorporeal membrane oxygenation in Latin America represents a challenge in this specialty field. The objective of this article was to describe the results of a new extracorporeal membrane oxygenation program in an intensive care unit.

Methods: This retrospective cohort study included 22 patients who required extracorporeal membrane oxygenation and were treated from January 2011 to June 2014.

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