Neurocritical Care Society Podcast

Latest Episodes:

Feb 14, 2019: Successful anesthetic wean following super-refractory status epilepticus despite emergence of ictal-interictal EEG patterns Feb 14, 2019

Show notes

Following refractory status epilepticus, the ictal-interictal EEG continuum can be as puzzling to intensivists as it can be to world-renowned epileptologists. Should you re-challenge with aggressive intravenous anesthetics? Or attempt to de-escalate therapy? This week on the NCS podcast, Dr. Starane Shepherd interviews Dr. Alvin Das on his recently published case series in Neurocritical Care that seeks to answer these questions.

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The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Fawaz Almufti, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Roosevere.

Das AS, Lee JW, Rosenthal ES and Vaitkevicius H. Successful Wean Despite Emergence of Ictal-Interictal EEG Patterns During the Weaning of Prolonged Burst-Suppression Therapy for Super-Refractory Status Epilepticus. Neurocritical care. 2018;29:452-462.

Jan 14, 2019: Tenecteplase versus alteplase before thrombectomy in acute ischemic stroke Jan 14, 2019

Show notes

The EXTEND-IA TNK trial showed that for acute ischemic stroke, intravenous tenecteplase was as effective as alteplase for achieving good functional outcomes in acute ischemic stroke due to large vessel occlusion--and it may even be superior to alteplase. Dr. Mike Brogan interviews Dr. Bruce Campbell about the results of this pivotal trial.

Campbell BCV, Mitchell PJ, Churilov L, et al. Tenecteplase versus Alteplase before Thrombectomy for Ischemic Stroke. The New England journal of medicine. 2018;378:1573-1582.

Dec 14, 2018: Single burr hole technique for intracranial monitoring in severe TBI Dec 14, 2018

Show notes

This week on the NCS podcast, Dr. Ramani Balu interviews Dr. Brandon Foreman about his recently published observational cohort study on multimodality monitoring in severe TBI. Together, they discuss the practical aspects (and limitations) of this increasingly popular tool in neurocritical care.

Foreman B, Ngwenya LB, Stoddard E, Hinzman JM, Andaluz N and Hartings JA. Safety and Reliability of Bedside, Single Burr Hole Technique for Intracranial Multimodality Monitoring in Severe Traumatic Brain Injury. Neurocritical care. 2018. Epub ahead of print.

Nov 14, 2018: Early hyperoxia in patients with traumatic brain injury Nov 14, 2018

Show notes

Hypoxemia in ICU patients has long been associated with poor clinical outcomes, but data pertaining to the prognosis with hyperoxia are lacking. This week on the NCS podcast, Dr. Levine interviews Dr. Andrew Udy on his multicenter retrospective cohort study that sought to clarify this relationsnhip.

The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere.

O Briain D, Nickson C, Pilcher DV and Udy AA. Early Hyperoxia in Patients with Traumatic Brain Injury Admitted to Intensive Care in Australia and New Zealand: A Retrospective Multicenter Cohort Study. Neurocritical care. 2018. Epub ahead of print.

Oct 14, 2018: Ten false beliefs in neurocritical care Oct 14, 2018

Show notes

A wise man once said, "traditions are often mistakes made more than once." To correct some of these traditions, Dr. Geert Meyfroidt shares his experience with Dr. Fawaz Almufti by describing 10 of the most important misunderstandings in neurocritical care.

Meyfroidt G, Menon D and Turgeon AF. Ten false beliefs in neurocritical care. Intensive care medicine. 2018. Epub ahead of print.

Sept 14, 2018: Acute organ dysfunction and long-term survival in sepsis Sep 14, 2018

Show notes

This month on the NCS podcast, Dr. Shepherd interviews Dr. Liu on his recent multi-center study on survival after sepsis with multi-organ dysfunction.

Schuler A, Wulf DA, Lu Y, et al. The Impact of Acute Organ Dysfunction on Long-Term Survival in Sepsis. Critical care medicine 2018; Epub ahead of print.

Aug 14, 2018: Epileptiform activity following TBI predicts later epilepsy Aug 14, 2018

Show notes

This month, Dr. Ramani Balu interviews Dr. Jennifer Kim on her research into the EEG biomarkers of post-traumatic epilepsy.

Kim JA, Boyle EJ, Wu AC, Cole AJ, Staley KJ, Zafar S, Cash SS and Westover MB. Epileptiform activity in traumatic brain injury predicts post-traumatic epilepsy. Annals of neurology. 2018;83:858-862.

July 14, 2018: Fluid therapy in neurointensive care patients Jul 14, 2018

Show notes

Dr. Mike Brogan interviews Dr. Mauro Oddo on the most recent ESICM practice guidelines on general fluid resuscitation management, hyperosmolar therapies, and the use of fluids in treating delayed cerebral ischemia for neurointensive care patients.

Oddo M, Poole D, Helbok R, Meyfroidt G, Stocchetti N, Bouzat P, Cecconi M, Geeraerts T, Martin-Loeches I, Quintard H, Taccone FS, Geocadin RG, Hemphill C, Ichai C, Menon D, Payen JF, Perner A, Smith M, Suarez J, Videtta W, Zanier ER and Citerio G. Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations. Intensive care medicine. 2018;44:449-463.

June 14, 2018: Lack of early improvement in acute ICH predicts poor outcome--Results from VISTA and PREDICT Jun 14, 2018

Show notes

It is unclear what threshold for early neurologic deterioration or improvement following intracerebral hemorrhage may predict long-term outcomes for these patients. Using data from the PREDICT and VISTA cohorts, Dr. Yogendrakumar and his team sought to evaluate what change in NIHSS is sufficient to predict long-term disability in patients with ICH. Drs. Yogendrakumar and Dowlatshahi discuss the results of their investigation with Dr. Siegler in this week's episode of the NCS podcast.

Yogendrakumar V, Smith EE, Demchuk AM, et al. Lack of Early Improvement Predicts Poor Outcome Following Acute Intracerebral Hemorrhage. Critical care medicine. 2018;46:e310-e317.

May 14, 2018: Brain oxygen optimization in severe traumatic brain injury--A Phase II trial May 14, 2018

Show notes

Multimodality monitoring is increasingly used in the neurocritical care setting. However, the safety and efficacy of certain methods for invasive neurodiagnostic surveillance have not been definitively established. Dr. Michael Brogan discusses how this paradigm is shifting with Dr. David Okonkwo given the recent results of the BOOST-2 randomized clinical trial.

Okonkwo DO, Shutter LA, Moore C, Temkin NR, Puccio AM, Madden CJ, Andaluz N, Chesnut RM, Bullock MR, Grant GA, McGregor J, Weaver M, Jallo J, LeRoux PD, Moberg D, Barber J, Lazaridis C and Diaz-Arrastia RR. Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial. Critical care medicine. 2017;45:1907-1914.

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