Mechanical ventilation for ischemic stroke and intracerebral hemorrhage

Gujjar, Arunodaya R.; Deibert, Ellen; Manno, Edward M.; Duff, Steven B.; Diringer, Michael N.

doi:10.1212/wnl.51.2.447

Cited by 201 publications

(119 citation statements)

References 3 publications

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“…20 before a diagnosis or prognosis can be defi ned. 8 Conversely, patients with many medical and some surgical diagnoses are more likely to have chronic comorbid illnesses related to their ICU admission. One prior study found that nurses rated quality of dying higher for neurology and neurosurgery patients than patients of other specialties.…”

Section: Variables Of Interest Outcome Measuresmentioning

confidence: 99%

Differences in End-of-Life Care in the ICU Across Patients Cared for by Medicine, Surgery, Neurology, and Neurosurgery Physicians

Kross

Engelberg

Cuschieri

et al. 2014

Chest

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Background: Some of the challenges in the delivery of high-quality end-of-life care in the ICU include the variability in the characteristics of patients with certain illnesses and the practice of critical care by different specialties. Methods: We examined whether ICU attending specialty was associated with quality of end-of-life care by using data from a clustered randomized trial of 14 hospitals. Patients died in the ICU or within 30 h of transfer and were categorized by specialty of the attending physician at time of death (medicine, surgery, neurology, or neurosurgery). Outcomes included family ratings of satisfaction, family and nurse ratings of quality of dying, and documentation of palliative care in medical records. Associations were tested using multipredictor regression models adjusted for hospital site and for patient, family, or nurse characteristics. Results: Of 3,124 patients, the majority were cared for by an attending physician specializing in medicine (78%), with fewer from surgery (12%), neurology (3%), and neurosurgery (6%). Family satisfaction did not vary by attending specialty. Patients with neurology or neurosurgery attending physicians had higher family and nurse ratings of quality of dying than patients of attending physicians specializing in medicine ( P , .05). Patients with surgery attending physicians had lower nurse ratings of quality of dying than patients with medicine attending physicians ( P , .05). Chart documentation of indicators of palliative care differed by attending specialty. Conclusions: Patients cared for by neurology and neurosurgery attending physicians have higher family and nurse ratings of quality of dying than patients cared for by medicine attending physicians and have a different pattern of indicators of palliative care. Patients with surgery attending physicians had fewer documented indicators of palliative care. These fi ndings may provide insights into potential ways to improve the quality of dying for all patients.

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Section: Variables Of Interest Outcome Measuresmentioning

confidence: 99%

Differences in End-of-Life Care in the ICU Across Patients Cared for by Medicine, Surgery, Neurology, and Neurosurgery Physicians

Kross

Engelberg

Cuschieri

et al. 2014

Chest

View full text Add to dashboard Cite

show abstract

“…Apart from having a higher risk of death, those who survive are frequently left with various degrees of functional and cognitive limitations. [2][3][4][5][6][7][8] Only a small number of specific interventions have been definitively demonstrated in large randomized controlled trials to improve outcomes in neurocritical care. [9][10][11][12][13][14] Many of the treatments that are recommended in consensus guidelines and incorporated into protocols are, by necessity, based on low-quality evidence derived largely from observational studies.…”

Section: Résumémentioning

confidence: 99%

“…Thus, the sum of individual diagnoses exceeds the total number of patients for a particular time period 3 Number of patients with missing data for variables: age (4); sex (0); Glasgow Coma Scale (12); APACHE II (24) reduction in the odds of hospital death from one time period to the next (Table 3). This association persisted with inclusion of the modified APACHE II score in the model as a potential confounder, rather than considering it to be an intermediate variable (OR 0.77, 95% CI 0.60 to 0.98, P = 0.03).…”

Section: Multivariable Analysismentioning

confidence: 99%

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Kramer

Zygun

2013

Can J Anesth/J Can Anesth

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“…Thirty percent of those with supratentorial ICH and the majority with cerebellar or brainstem ICH require intubation for airway protection [55]. Intubation can prevent aspiration and maximize oxygenation, but these benefits should be weighed against potential risks of intubation in the acute phase [56].…”

Section: Airway Protectionmentioning

confidence: 99%

Therapeutic Strategies in Acute Intracerebral Hemorrhage

Brouwers

Goldstein

2012

Neurotherapeutics

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Mechanical ventilation for ischemic stroke and intracerebral hemorrhage

Abstract: MV in acute stroke is associated with high mortality. Mortality and outcome were similar for ISCH and HEM; however, the factors predictive of outcome may differ and influence decisions about the use of MV in such patients.

Cited by 201 publications

References 3 publications

Differences in End-of-Life Care in the ICU Across Patients Cared for by Medicine, Surgery, Neurology, and Neurosurgery Physicians

Differences in End-of-Life Care in the ICU Across Patients Cared for by Medicine, Surgery, Neurology, and Neurosurgery Physicians

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Therapeutic Strategies in Acute Intracerebral Hemorrhage

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