The Jefferson Manual for Neurocritical Care

 

Description:

The quintessential reference for bedside medical management of neurocritical care patients

Medical management of patients in the neurocritical care unit (NCCU) often spells the difference between life or death and return to normal function or a lifetime disability. As such, it is vital that patients with life-threatening neurological and neurosurgical illnesses receive prompt diagnosis and rapid interventions in the NCCU.

The Jefferson Manual for Neurocritical Care by renowned neurosurgeon Jack I. Jallo, neurointensive care physician Jacqueline S. Urtecho, and distinguished colleagues is a high-yield pocket resource ideal for the bedside care of patients with serious, life-altering diseases. Nineteen concise chapters encompass cerebrovascular, neuromuscular, oncologic, and traumatic conditions, as well as core clinical topics applicable to the care of neurocritical patients.
This book includes complimentary access to a digital copy on https://medone.thieme.com.

Key Highlights:

Evidence-based management strategies created at Thomas Jefferson University's Vickie and Jack Farber Institute for Neuroscience presented in reader-friendly algorithms, pictures, and charts

General chapters cover brain death, sodium dysregulation, nutrition, sedation, pain management, neuromonitoring, and ventilation strategies

Disease-specific chapters featuring succinct, bulleted format include epidemiology, causes, diagnostic tests, treatment options, symptoms, common clinical presentation, risk factors, differential diagnoses, and more

This manual is an indispensable resource for neurocritical care residents and fellows, NCCU nurses, nurse practitioners, physician assistants, general intensive care physicians, and neurointensivists.

 

Table of Contents:

 

 

1. Encephalopathy and Delirium

 

1.1 Encephalopathy

1.1.1 Definition

1.1.2 Causes of Encephalopathy

1.1.3 Diagnosis of Encephalopathy

1.1.4 Treatment of Encephalopathy

1.1.5 Relationship to Delirium

1.2 Delirium

1.2.1 Definition

1.2.2 Duration of Symptoms

1.2.3 Level of Activity

1.2.4 Risk Factors for Delirium

1.2.5 Clinical Assessment

1.3 Treatment

1.3.1 Medications for Agitation

1.3.2 Pharmacologic Management of Hyperactive Delirium and Agitation

1.3.3 Nonpharmacologic Treatments for Delirium

2. Cerebrovascular Emergency: Acute Stroke Diagnosis and Management

2.1 Epidemiology

2.2 Etiology

2.2.1 Nonmodifiable Risk Factors

2.2.2 Modifiable Risk Factors

2.2.3 Stroke Subtypes

2.3 Common Clinical Presentations

2.4 Differential Diagnosis for Acute Ischemic Stroke

2.5 Acute Stroke Diagnosis, Treatment, and Management

2.5.1 Stroke Activation

2.6 Criteria for Endovascular Therapy

2.6.1 Neurocritical Care Management of Ischemic Stroke

2.7 Stroke Workup and Management

2.7.1 Post Stroke Complication

3. Cerebrovascular Emergency: Spontaneous Intracerebral Hemorrhage (ICH)

3.1 Epidemiology

3.2 Etiologies/Differential Diagnosis

3.3 Common Clinical Presentations

3.4 Neuroimaging

3.5 Treatment

3.5.1 Aggressive Reduction in SBP to Goal of 140

3.5.2 Seizures

3.5.3 Intracranial Pressure

3.5.4 Medical Issues

3.5.5 Coagulopathies

3.5.6 Surgical Options

3.5.7 Craniotomy

3.5.8 Craniectomy

3.5.9 Minimally Invasive Surgical Evacuation

3.6 Prognosis

4. Cerebrovascular Emergencies: Aneurysmal Subarachnoid Hemorrhage (SAH)

4.1 Epidemiology

4.2 Risk Factors

4.3 Diagnosis

4.4 Grading System

4.4.1 Hunt and Hess Grade

4.4.2 World Federation of Neurological Surgeons Grade

4.4.3 Modified Fischer Scores

4.5 Management of Subarachnoid Hemorrhage

4.5.1 Early Phase

4.5.2 Late Phase

4.6 Vasospasm, Delayed Neurologic Deterioration (DND), and Delayed Cerebral Ischemia (DCI)

4.6.1 Detection and Management of Vasospasm and DCI

4.7 Hyponatremia and Endocrine Dysfunction

4.7.1 Hyponatremia

4.7.2 Endocrine Dysfunction

5. Transfusion Medicine and Anticoagulation

5.1 Introduction

5.2 Anemia in the ICU

5.3 Red Cell Transfusion

5.3.1 Leukocyte Reduction Indications

5.3.2 Washed RBC

5.3.3 Irradiation

5.3.4 Complications of Red Blood Cell Transfusion

5.3.5 Benefits to Transfusion

5.4 Hemoglobin “Triggers”

5.5 Thrombocytopenia

5.6 Prophylaxis Thresholds

5.6.1 Treatment of Bleeding

5.7 Antiplatelet Reversal in Intracranial Hemorrhage

5.8 Coagulation Cascade and Anticoagulants

5.9 Anticoagulants

5.9.1 Warfarin

5.10 Oral Factor Xa Inhibitors

5.10.1 Apixaban, Rivaroxaban, Edoxaban

5.11 Thrombin Inhibitors

5.11.1 Oral

5.11.2 Intravenous

5.12 The Heparins

5.12.1 Unfractionated Heparin

5.12.2 Low-Molecular-Weight Heparin (LMWH)

5.12.3 Fondaparinux

5.13 Deep Vein Thrombosis (DVT) Prophylaxis

6. Cerebral Edema and Elevated Intracranial Pressure

6.1 The Basics

6.1.1 Monro-Kellie Doctrine

6.1.2 ICP and Cerebral Perfusion Pressure (CPP)

6.1.3 Intracranial Compliance

6.1.4 ICP Waveforms and Herniation Syndromes

6.2 Cerebral Edema

6.3 Stepwise Approach to the Management of Elevated ICP

6.4 Management of Increased Intracranial Pressure

6.4.1 Tier 1

6.4.2 Tier 2

6.4.3 Tier 3

7. Fevers and Infections in the Neuro-ICU

7.1 Brain

7.1.1 Meningitis

7.1.2 Acute Bacterial Meningitis

7.1.3 Aseptic Meningitis

7.1.4 Viral Meningitis

7.1.5 Fungal Meningitis

7.1.6 Ventriculitis

7.1.7 HIV-Related Infections

7.1.8 Empyema

7.2 Spine

7.2.1 Epidural Abscess

7.2.2 Osteomyelitis

7.3 Central Fever

8. Treatment of Status Epilepticus in Adults

8.1 Overview and Definitions

8.2 Convulsive Status Epilepticus Management

8.3 Nonconvulsive Status Epilepticus (NCSE)

8.4 Refractory Status Epilepticus (RSE)

8.5 Super Refractory Status Epilepticus (SRSE)

9. Trauma

9.1 Acute Spinal Cord Injury

9.1.1 Introduction

9.1.2 Medical Treatment of Acute SCI

9.1.3 Surgical Management of Acute SCI

9.2 Traumatic Brain Injury

9.2.1 Introduction

9.2.2 Management of Elevated ICP

9.2.3 Other Post-TBI Considerations

9.3 Paroxysmal Sympathetic Hyperactivity (PSH)

10. Neuromuscular and Other Neurologic Emergencies

10.1 Guillain-Barré Syndrome (GBS)/Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP)

10.1.1 Definition

10.1.2 Epidemiology

10.1.3 Differential Diagnosis

10.1.4 Common Clinical Presentation

10.1.5 Diagnosis

10.1.6 GBS Variants

10.1.7 Ancillary Testing

10.1.8 Complications of GBS

10.1.9 Management

10.1.10 Prognosis

10.2 Myasthenia Gravis

10.2.1 Definition

10.2.2 Epidemiology

10.2.3 Differential Diagnosis

10.2.4 Clinical Presentation of Generalized Myasthenia Gravis

10.2.5 Diagnosis

10.2.6 Management of Myasthenic Crisis

10.2.7 Prognosis

10.3 Botulism

10.3.1 Definition

10.3.2 Epidemiology

10.3.3 Pathophysiology

10.3.4 Differential Diagnosis

10.3.5 Clinical Presentation

10.3.6 Diagnosis

10.3.7 Management

10.3.8 Prognosis

10.4 Organophosphate Toxicity

10.4.1 Definition

10.4.2 Epidemiology

10.4.3 Pathophysiology

10.4.4 Differential Diagnosis

10.4.5 Clinical Presentation

10.4.6 Diagnosis

10.4.7 Management

10.4.8 Prognosis

10.5 Neuroleptic Malignant Syndrome (NMS) and Serotonin Syndrome (SS)

10.5.1 Definition

10.5.2 Epidemiology

10.5.3 Pathogenesis

10.5.4 Differential Diagnosis

10.5.5 Clinical Presentation

10.5.6 Diagnosis

10.5.7 Management

10.5.8 Complications

10.5.9 Prognosis

11. Brain Tumor Postoperative Management

11.1 Introduction

11.1.1 Clinical Presentation

11.1.2 Tumor Classification

11.2 Postoperative Care and Complications

11.2.1 Airway Management

11.2.2 Blood Pressure Control and Postoperative Hemorrhage

11.2.3 Seizure Prophylaxis

11.2.4 Venous Thromboembolism Prophylaxis

11.2.5 Antibiotic Prophylaxis and Postoperative Infection

11.2.6 Cerebral Edema

11.2.7 CSF Leak

11.3 Specific Concerns for Sellar and Parasellar Tumors

11.3.1 Hormonal Dysregulation

11.3.2 Pituitary Apoplexy

11.4 Conclusion

12. Brain Death in Adults

12.1 Definition of Brain Death

12.2 Clinical Evaluation

12.2.1 Establishing the Proximate Cause of Coma

12.2.2 Clinical Examination to Establish Irreversibility

12.3 Ancillary Tests

12.4 Legal

12.5 Management of the Brain-Dead Patient for Organ Donation

13. Sodium Dysregulation

13.1 Terminology

13.2 Hyponatremia Classification

13.2.1 Causes of Hyponatremia

13.2.2 Symptomatic Hyponatremia

13.3 SIADH versus CSW

13.3.1 Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

13.3.2 Cerebral Salt Wasting (CSW)

13.3.3 SIADH and CSW Diagnosis

13.4 Diagnostic Approach to Hyponatremia

13.4.1 Hyponatremia Treatment: General Principles

13.4.2 Acute Symptomatic Moderate to Severe Hyponatremia

13.4.3 Acute Asymptomatic Moderate Hyponatremia

13.4.4 Severe Chronic Mild-Moderate Hyponatremia

13.4.5 SIADH Treatment

13.4.6 CSW Treatment

13.4.7 Treatment of Hyponatremia in Patients with Subarachnoid Hemorrhage

13.4.8 Treatment of Hyponatremia in Patients with Heart Failure

13.5 Hypernatremia

13.5.1 Central (Neurogenic) Diabetes Insipidus

13.5.2 Nephrogenic Diabetes Insipidus

13.6 Diagnostic Approach to Hypernatremia

13.6.1 Treatment

13.6.2 Central DI Treatment

13.6.3 Nephrogenic DI Treatment

14. Nutrition

14.1 Glucose Utilization

14.2 Nutrition in Critical Care

14.3 Nutrition Status

14.3.1 Malnutrition

14.3.2 Refeeding Syndrome

14.3.3 Nutrition-Related Laboratory Tests

14.4 Nutrition Assessment

14.4.1 Calorie Needs

14.4.2 Protein Needs

14.4.3 Nutrition Support

14.4.4 Enteral Nutrition

14.5 Specific EN Considerations

14.5.1 Parenteral Nutrition

14.6 Therapy-Specific Considerations

14.7 Conclusion

15. Sedation

15.1 Introduction

15.2 Indications for Sedation

15.3 Complications of Sedation

15.4 Assessment of Sedation

15.5 Choice of Sedative

15.5.1 Propofol (Diprivan)

15.5.2 Midazolam (Versed)

15.5.3 Dexmedetomidine (Precedex)

15.5.4 Fentanyl (Sublimaze)

15.5.5 Ketamine (Ketalar)

16. Pain Management in the Neuro-Intensive Care Unit (ICU)

16.1 Introduction

16.2 Modern Strategy of Pain Management in ICU Liberation

16.3 Challenges of Pain Management in Neuro-ICU

16.4 Individualizing Therapy in NICU

16.4.1 Pharmacologic Interventions of Pain

16.4.2 Nonpharmacologic Approach

16.5 Neuro-specific Diseases at Risk for Pain

16.5.1 Pain with SAH

16.5.2 Spondylosis and Disk Herniation

16.5.3 Spasticity

16.6 Ongoing Continuous Pain Monitoring in NICU

16.6.1 Pain Scales

17. Advanced Hemodynamic and Neurological Monitoring in the Neuro-ICU

17.1 Hemodynamic Monitoring

17.1.1 Invasive Monitoring: Pulmonary Thermodilution

17.1.2 Less Invasive: Transpulmonary Thermodilution

17.1.3 Minimally Invasive Monitoring: Pulse Contour Analysis

17.1.4 Noninvasive Hemodynamic Monitoring

17.2 Neurological Monitoring

17.2.1 Noninvasive Monitors

17.2.2 Invasive Monitors: Cerebral Oximetry

17.2.3 Cerebral Blood Flow Monitors

17.2.4 Intracranial Pressure Monitoring

18. Neuroimaging

18.1 Introduction

18.2 Types of Imaging

18.2.1 Brain Imaging

18.2.2 Spine Imaging

18.3 Advantages and Limitations

18.3.1 Brain Imaging

18.3.2 Spine Imaging

18.3.3 Systemic

19. Ventilation Strategies in Neuro-ICU

19.1 Introduction

19.2 Respiratory Failure

19.2.1 Noninvasive Oxygenation and Ventilation

19.2.2 Invasive Mechanical Ventilation

19.2.3 Basic Principles of Mechanical Ventilation

19.2.4 Modes of Ventilation

19.2.5 Initial Ventilator Settings

19.2.6 For Pressure Ventilation

19.2.7 Common Ventilator Problems

19.2.8 Weaning from Ventilator

19.2.9 WHEANS NOT Mnemonic

19.2.10 Extubation Procedure

Index

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An aparitie	2021
Autor	Jack I. Jallo, Jacqueline Urtecho
Dimensiuni	20.32 x 12.7 cm
Editura	Thieme
Format	Paperback
ISBN	9781626234949
Limba	Engleza
Nr pag	326
Versiune digitala	DA