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Rapid progress in technology and its application to diagnosis and monitoring of brain tissue temperature and metabolism have resulted in advances in the therapy for critically brain-injured patients and breakthroughs in understanding the pathophysiology of brain damage. The latest concept of brain hypothermia therapy clarifies targets such as brain thermal pooling, masking brain hypoxia associated with catecholamine surge, the metabolic shift from glucose to lipids, and selective radical damage of dopamine in the central nervous system. This volume explains the mechanism of brain injury and how brain hypothermia treatment differs from other hypothermia therapy in four major sections: Brain Injury Mechanism, Pathophysiology of Hypothermia, Basic Research of Hypothermia Treatment, and Clinical Studies of Brain Hypothermia. The book is a valuable source for practitioners and researchers in neurosurgery and neurology and in critical care and emergency medicine.
Over the past decade, the hospitalist model has become a dominant system for the delivery of inpatient care. Forces such as national mandates to improve safety and quality, and intense pressure to safely reduce length of hospital stays, are now exerting pressure on neurologists. To meet these challenges, a new neurohospitalist model is emerging. This is the first authoritative text to detail the advances and strategies for treating neurologic disease in a hospital setting. It includes chapters on specific acute neurologic diseases including stroke, epilepsy, neuromuscular disease and traumatic brain injury and also addresses common reasons for neurologic consultation in the hospital including encephalopathy, electrolyte disturbances and neurologic complications of pregnancy. Ethical and structural issues commonly encountered in neurologic inpatients are also addressed. This will be a key resource for any clinician or trainee caring for neurologic patients in the hospital including practising neurologists, internists and trainees across multiple subspecialities.
This volume contains the most recent works on intracranial pressure and neuromonitoring in brain injury selected from 300 abstracts submitted to the 10th International Symposium on Intracranial Pressure. It includes state of the art monitoring of the brain injured patient in intensive care as well as the current state of knowledge in neurochemical and oxygen monitoring of the injured brain. Recent advances in molecular mechanisms of injury and the pathophysiology of ischemia and trauma are also included. "... this publication presents a comprehensive survey of the present state of art in the field and thus gives directions for further research to those engaged in ICP measurement and neuromonitoring”. Intensive Care Med
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
The critical care unit manages patients with a vast range of disease and injuries affecting every organ system. The unit can initially be a daunting environment, with complex monitoring equipment producing large volumes of clinical data. Core Topics in Critical Care Medicine is a practical, comprehensive, introductory-level text for any clinician in their first few months in the critical care unit. It guides clinicians in both the initial assessment and the clinical management of all CCU patients, demystifying the critical care unit and providing key knowledge in a concise and accessible manner. The full spectrum of disorders likely to be encountered in critical care are discussed, with additional chapters on transfer and admission, imaging in the CCU, structure and organisation of the unit, and ethical and legal issues. Written by Critical Care experts, Core Topics in Critical Care Medicine provides comprehensive, concise and easily accessible information for all trainees.
This book provides a comprehensive overview of the multitude of different forms of thermotherapy in connection with aspects of thermal physiology and cell biology. The aim is to elucidate the scientific background of therapeutic actions and to promote effective new applications at the beginning of the 21st century. Significant to these purposes is cooperation between experts in the fields of thermal biology, hyper thermic oncology, rheumatology, and balneology, as represented by the editors. Emphasis has been placed on a balanced choice of contributions, in the hope that this will enable the reader to draw helpful connections between the principles and prac tice of thermotherapy. It is apparent that a wealth of published data exists concerning thermotherapy on the one hand and thermal physiology on the other. However, in the former field empirical aspects of therapeutic usefulness prevail, while in the latter, aspects of basic science are in the foreground. Accordingly, the sources where published data may be found are quite different and as a consequence many findings of potential mutual interest published in medical journals have gone unnoticed by readers of physio logical journals, and vice versa. It is hoped that this book will bridge the gap and encourage researchers' efforts to integrate the available knowledge to attain optimal coordination of clinical and theoretical aspects.
Recent breakthroughs in understanding the effectiveness of brain hypothermia treatment have been brought about by rapid progress in experimental gene studies along with new findings in the areas of brain-injury mechanisms, brain thermo-pooling, hemoglobin dysfunction, insulin-resistant hyperglycemia, radical damage involving states of consciousness, management of lipid-dominant metabolism in the intensive care unit (ICU), and management of immune crises under conditions of hypothermia. This book explains the mechanism of brain hypothermia and presents advanced techniques for ICU management of brain hypothermia for critically brain-injured patients. Especially useful for bedside care in the ICU are the easy-reference care-management "cards" in the appendix of the book. Brain Hypothermia Treatment provides a valuable resource and practical guide for professionals in the fields of neurosurgery and emergency and critical care medicine.
A distinction between primary and secondary brain damage of vari ous origin, particularly in acute lesions, such as head injury and ische mia is not entirely new. The concept is of practical significance, be cause it is the foremost intention of all clinical efforts to prevent, or at least attenuate the development of secondary sequelae. Primary dam age to nervous elements usually cannot be influenced by treatment. Its prevention is the objective of prophylactic measures. The current volume gathered prominent scientists and clinicians from various fields to pro vide a competent introduction and survey of the various aspects involved in secondary brain damage. It was attempted to provide criteria for the distinction between the primary and secondary phenomena on a morpho logical and functional level, on the basis of the kinetics involved and, most importantly, regarding the different specific manifestations, such as disturbances of microcirculation, aspects of the blood-brain barrier, and of cellular structure and function at a molecular level. Although it was not expected that a grand unifying hypothesis will be reached recon cilable with the many, occasionally opposing views on such a complex subject, nevertheless, the present volume attains an appropriate result. It can best be described as a mosaic of many different pieces which only as an ensemble reflect the current state of the art.
This book offers valuable guidance to neurointensivists, other neurocritical care staff, and those desiring to develop a neurocritical care unit via a thorough discussion of neurological emergencies and neurocritical care unit organization. This comprehensive volume begins with a review of acute neurological emergencies as managed clinically in the neurocritical care unit. Topics include acute cerebrovascular, neurological, and neurosurgical disorders. The unique aspect of this book is its description of the organization of the neurocritical care unit. We focus on how other services in the hospital interact with and assist neurocritical care operations, telemedicine/telestroke, and neurocritical care personnel and their roles. A review of expected outcomes of neurocritical care conditions is also included. Neurointensivists, neurocritical care unit staff leadership, hospital administrators, and those interested in developing a neurocritical care unit will find Neurointensive Care Unit: Clinical Practice and Organization to be an invaluable guide.
This volume provides an overview of the most important current controversies in the field of pediatric intensive care. Organized into sections based on organ systems, the text focuses on controversies surrounding disease processes of the cardiac, respiratory, gastrointestinal, hematologic / immunologic, endocrine, and neurologic systems. Each chapter reviews the pros and cons of specific management approaches through case studies and the most up-to-date evidence-based resources, and concludes with bulleted take-home points for ease of use. Written by experts in the field, Pediatric Critical Care: Current Controversies is a valuable resource for intensivists, advanced practice providers, nurses, and other health care providers involved in the care of critically-ill children.