Increased protocol adherence and safety during controlled normothermia as compared to hypothermia after cardiac arrest.

Purpose: This study aims to compare protocol adherence, neurological outcome and adverse effects associated with a controlled hypothermia versus a controlled normothermia protocol in patients successfully resuscitated after cardiac arrest.

Methods: In this retrospective single-center study in a university intensive care unit in Switzerland, post-cardiac arrest patients were compared before and after a protocol change from targeted temperature management at 33 °C (TTM-33) to 36 °C (TTM-36) using an intravascular cooling device. Protocol adherence was assessed as the primary outcome.

Implementation of a multiprofessional, multicomponent delirium management guideline in two intensive care units, and its effect on patient outcomes and nurse workload: a pre-post design retrospective cohort study.

Aim Of The Study: Delirium is a frequent intensive care unit (ICU) complication, affecting 26% to 80% of ICU patients, often with serious consequences. This study aimed to evaluate the effectiveness, costs and benefits of following a standardised multiprofessional, multicomponent delirium guideline on eight outcomes: delirium prevalence and duration, lengths of stay in ICU and hospital, in-hospital mortality, duration of mechanical ventilation, and cost and nursing hours per case. It also aimed to explore the associations of delirium with length of ICU stay, length of hospital stay and duration of mechanical ventilation.

A hospital-wide evaluation of delirium prevalence and outcomes in acute care patients - a cohort study.

Background: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case.

Neurologic Injury With Severe Adult Respiratory Distress Syndrome in Patients Undergoing Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Analysis.

This retrospective single-center study investigated the incidence of neurologic injury as determined by autopsy or cerebral imaging in 74 patients undergoing extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome. Seventy-three percent of patients were treated with venovenous and 27% with venoarterial ECMO. ECMO-associated intracerebral hemorrhage was diagnosed in 10.

The effect of sampling rate and lowpass filters on saccades - A modeling approach.

The study of eye movements has become popular in many fields of science. However, using the preprocessed output of an eye tracker without scrutiny can lead to low-quality or even erroneous data. For example, the sampling rate of the eye tracker influences saccadic peak velocity, while inadequate filters fail to suppress noise or introduce artifacts.

Saccadic eye movement performance as an indicator of driving ability in elderly drivers.

Objective: Regular checking of the fitness to drive of elderly car-license holders is required in some countries, and this will become increasingly important as more countries face aging populations. The present study investigated whether the analysis of saccadic eye movements could be used as a screening method for the assessment of driving ability.

Methods: Three different paradigms (prosaccades, antisaccades, and visuovisual interactive (VVI) saccades) were used to test saccadic eye movements in 144 participants split into four groups: elderly drivers who came to the attention of road authorities for suspected lack of fitness to drive, a group of elderly drivers who served as a comparison group, a group of neurology patients with established brain lesion diagnoses, and a young comparison group.

Amyotrophic lateral sclerosis after embolization of cerebral arterioveneous malformations.

Cerebral arterioveneous malformations (AVM) can cause neurological symptoms and carry a risk of hemorrhage. Therapeutic options to cure or reduce AVM include surgery, embolization, irradiation, and combinations thereof. Prompted by three index cases treated in our center, we studied whether AVM embolization is associated with an increased risk of subsequent amyotrophic lateral sclerosis (ALS).

Saccadic eye movements after low-dose oral alcohol exposure.

Objectives: The influence of low-dose alcohol intake on reflexive visually guided saccades was investigated.

Methods: 40 healthy human subjects were orally given alcohol resulting in low-dose alcohol concentration (less than 0.8‰) blood alcohol concentration.

Complete graft dehiscence 8 months after repair of acute type A aortic dissection.

Acute type A aortic dissection is a dreaded differential diagnosis of acute chest pain. Long-term outcome mainly depends on pre-existing comorbidities and post-operative complications. We present a patient with aortic graft dehiscence and subsequent severe aortic regurgitation due to fungal graft infection 8 months after repair of acute type A aortic dissection.

Cognitive performance in high-altitude climbers: a comparative study of saccadic eye movements and neuropsychological tests.

Impairment of cognitive performance during and after high-altitude climbing has been described in numerous studies and has mostly been attributed to cerebral hypoxia and resulting functional and structural cerebral alterations. To investigate the hypothesis that high-altitude climbing leads to cognitive impairment, we used of neuropsychological tests and measurements of eye movement (EM) performance during different stimulus conditions. The study was conducted in 32 mountaineers participating in an expedition to Muztagh Ata (7,546 m).

Carotid artery stenting: a single center "real world" experience.

Background: Percutaneous carotid artery stenting (CAS) became a widely used procedure in patients with symptomatic and asymptomatic carotid artery stenosis. However its role compared to carotid endarterectomy (CAD) remains questioned. We analysed the safety of carotid artery stenting program of a prospective CAS register program of a tertiary teaching hospital.

Influence of plaque volume on hemodynamic response and stress hormone release in patients undergoing carotid artery stenting.

Aim: Carotid artery stenting (CAS) may cause bradycardia and hypotension due to barostimulation. The impact of periprocedural hypotension on CAS outcome remains controversial. The role of carotid plaque volume and catecholamine hormone release during CAS on hemodynamic changes has not been investigated so far.

Subacute bilateral visual loss in methylmalonic acidemia.

A 23-year-old woman known to have methylmalonic acidemia (MMA) since birth suffered bilateral visual loss within 5 days. Multiple sclerosis, Leber hereditary optic neuropathy, vasculitis, infections (in particular treponema), and vitamin deficiency were ruled out. The optic nerve head changed from normal in appearance to atrophic.

Treatment of resistant fever: new method of local cerebral cooling.

Background: Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to evaluate its effectiveness as a surrogate endpoint to indicate the feasibility of neck cooling as a new method for intractable fever.

Methods: Nine patients with ten episodes of intractable fever and aneurysmal subarachnoid hemorrhage were treated with one of two different shapes of specifically adapted cooling neck pads.

Influence of global motion onset on goal-directed eye movements.

Saccades are very rapid eye movements in between two phases of fixation, which offer a precise measure of behaviour for the direction of the spotlight of attention. The onset of global motion is known to attract our attention reflexively. We asked whether brief global motion stimuli are able to modify the execution of saccades.

Hydrocephalus communicans after traumatic upper cervical spine injury with a cerebrospinal fluid fistula: a rare complication.

Secondary hydrocephalus communicans after traumatic upper cervical spine injuries with leakage of cerebrospinal fluid is a rare and hardly described complication. A case of a 75-year-old woman sustained a type II dens axis without other injuries, especially without evidence of a hydrocephalus in the primary CT scan. Dorsal atlanto-axial fusion was performed.

Comparison of spectral entropy and bispectral index electroencephalography in coronary artery bypass graft surgery.

Objective: The study's aim was to compare response entropy (RE) and state entropy (SE) with bispectral index (BIS) electroencephalography (EEG) as an alternative cerebral monitoring tool in patients scheduled for coronary artery bypass graft surgery.

Design: Prospective, observational single-center study.

Setting: University hospital.