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Management of Medical Complications in the Neurosciences Critical Care Unit

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Book cover Critical Care Neurology and Neurosurgery

Part of the book series: Current Clinical Neurology ((CCNEU))

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Abstract

Neurosciences critical care units (NSU) were designed for the care of neurologic and neurosurgical patients and, as we will discuss, virtually any medical complication can occur during their hospitalization in this unit. However, neurologic and neurosurgical patients have specific conditions that predispose them to developing certain complex clinical entities, which may not only influence mortality but also functional outcome in this patient population.

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References

  1. Rello J, Ausina V, Castella J, Net A, Prats G. Nosocomial respiratory tract infections in multiple trauma patients. Incidence of level of consciousness with implications for therapy. Chest 1992; 102: 525–529.

    Article  CAS  PubMed  Google Scholar 

  2. Schmidt E, Smirnov V, Ryabova V. Results of the seven-year prospective study of stroke patients. Stroke 1988; 19: 942–949.

    Article  Google Scholar 

  3. Kim H, Chung CS, Lee KH, Robbins J. Aspiration subsequent to a pure medullary infarction: lesion sites, clinical variables, and outcome. Arch. Neurol. 2000; 57: 478–483.

    Article  CAS  PubMed  Google Scholar 

  4. Meng Nh, Wang TG, Lien IN. Dysphagia in patients with brainstem stroke: incidence and outcome. Am. J. Phys. Med. Rehabil. 2000; 79: 170–175.

    Article  CAS  PubMed  Google Scholar 

  5. Nakagawa T, Sekizawa K, Arai H, et al. High incidence of pneumonia in elderly patients with basal ganglia infarction. Arch. Intern. Med. 1997; 157: 321–324.

    Article  CAS  PubMed  Google Scholar 

  6. Nakajoh K, Nakagawa T, Sekizawa K, et al. Relation of pneumonia and protective reflexes in post-stroke patients with oral or tube feeding. J. Intern. Med. 2000; 247: 39–42.

    Article  CAS  PubMed  Google Scholar 

  7. Park RH, Allison MC, Lang J, et al. Randomised comparison of percutaneous endoscopic gastrostomy and nasogastric tube feeding in patients with persisting neurological dysphagia. BMJ 1992; 304: 1406–1409.

    Google Scholar 

  8. Dray TG, Hillel AD, Miller RM. Dysphagia caused by neurologic deficits. Otolaryngol. Clin. North Am. 1998; 31: 507–524.

    Article  CAS  PubMed  Google Scholar 

  9. Kaye G, Zorowitz R, Baredes S. Role of flexible laryngoscopy in evaluating aspiration. Ann. Otol. Rhinol. Laryngol. 1997; 106: 705–709.

    CAS  PubMed  Google Scholar 

  10. Collins MJ, Bakheit AM. Does pulse oximetry reliably detect aspiration in dysphagic stroke patients? Stroke 1997; 28: 1773–1775.

    Article  CAS  PubMed  Google Scholar 

  11. Nash N. Swallowing problems in the tracheomized patient. Otolaryngol. Clin. North Am. 1988; 17: 701–709.

    Google Scholar 

  12. Potts RG, Zaroukian MH, Guerrero PA, Baker CD. Comparison of blue dye visualization and glucose oxidase test strip methods for detecting pulmonary aspiration of enteral feedings in intubated patients. Chest 1993; 103: 117–121.

    Article  CAS  PubMed  Google Scholar 

  13. Kollef MA. The prevention of ventilator-associated pneumonia. N. Engl. J. Med. 1999; 340: 627–634.

    Article  CAS  PubMed  Google Scholar 

  14. Coplin WM, Pierson DJ, Cooley KD, et al. Implications of extubation delay in brain injured patients meeting standard weaning criteria. Am. J. Respir. Crit. Care Med. 2000; 161: 1530–1536.

    CAS  PubMed  Google Scholar 

  15. Grau AJ, Buggle F, Schnitzler P, Spiel M, Lichy C, Hacke W. Fever and infection early after ischemic stroke. J. Neurol. Sci. 1999; 171: 115–120.

    Article  CAS  PubMed  Google Scholar 

  16. Boque MC, Bodi M, Rello J. Trauma, head injury, and neurosurgery infections. Semin. Resp. Infect. 2000; 15: 280–286.

    Article  CAS  Google Scholar 

  17. Gilbert DN, Moellering RC, Sande MA. The Sanford Guide to Antimicrobial Therapy, 31st ed. Hyde Park, VT: Antimicrobial Therapy, 2001.

    Google Scholar 

  18. Androgue HJ, Madias NE. Hyponatremia. N. Engl. J. Med. 2000; 342: 1581–1589.

    Article  Google Scholar 

  19. Suarez JI, Cohen ML, Larkin J, Kernich CA, Hricik DE, Daroff RB. Acute intermittent porphyria: clinicopathologic correlation. Neurology 1997; 48: 1678–1683.

    Article  CAS  PubMed  Google Scholar 

  20. Harrigan MR. Endocrine and metabolic dysfunction syndromes in the critically ill. Cerebral salt wasting syndrome. Crit. Care Clin. 2001; 17: 125–138.

    Google Scholar 

  21. Nelson PB, Seif SM, Maroon JC, et al. Hyponatremia in intracranial disease: perhaps not the syndrome of inappropriate secretion of antidiuretic hormone. Neurosurgery 1981; 55: 938–941.

    Article  CAS  Google Scholar 

  22. Laureno R, Illowsky K. Myelinolysis after correction of hyponatremia. Ann. Intern. Med. 1997; 126: 57–62.

    CAS  PubMed  Google Scholar 

  23. Woo MH, Kale-Pradhan PB. Fludrocortisone in the treatment of subarachnoid hemorrhage-induced hyponatremia. Ann. Pharmacother. 1997; 31: 637–639.

    CAS  PubMed  Google Scholar 

  24. Mori T, Katayama Y, Kawamata T, Hyrayama T. Improved efficiency of hypervolemic therapy with inhibition of natriuresis by fludrocortisone in patients with aneurysmal subarachnoid hemorrhage. J. Neurosurg. 1999; 91: 947–952.

    Article  CAS  PubMed  Google Scholar 

  25. Wong MF, Chin NM, Lew TW. Diabetes insipidus in neurosurgical patients. Ann. Acad. Med. Singapore 1998; 27: 340–343.

    CAS  PubMed  Google Scholar 

  26. Shucart WA, Jackson I. Management of diabetes insipidus in neurosurgical patients. J. Neurosurg. 1976; 44: 65–71.

    Article  CAS  PubMed  Google Scholar 

  27. Androgue HJ, Madias NE. Hypernatremia. N. Engl. J. Med. 2000; 342: 1493–1499.

    Article  Google Scholar 

  28. Gariballa, Robinson TG, Fotherby MD. Hypokalemia and potassium excretion in stroke patients. J. Am. Geriatr. Soc. 1997; 45: 1454–1458.

    Google Scholar 

  29. Pomeranz S, Constantini S, Pappaport ZH. Hypokalemia in severe head trauma. Acta. Neurochir. 1989; 97: 62–66.

    Article  CAS  PubMed  Google Scholar 

  30. Gennari JF. Hypokalemia. N. Engl. J. Med. 1998; 339: 451–458.

    Article  CAS  PubMed  Google Scholar 

  31. Savarese JJ, Caldwell, Lien CA, Miller R. Pharmacology of muscle relaxants and their antagonist. In Miller RD, ed. Anesthesia. Philadelphia: Churchill Livingstone, 2000: 412–490.

    Google Scholar 

  32. Fink EB. Magnesium deficiency. Etiology and clinical spectrum. Acta. Med. Scand. 1981; 647: 125–137.

    Google Scholar 

  33. Polderman KH, Bloemers FW, Peederman SM, Girbes AR. Hypomagnesemia and hypophosphatemia at admission in patients with severe head injury. Crit. Care Med. 2000; 28: 2022–2025.

    Article  CAS  PubMed  Google Scholar 

  34. Zivin JR, Goolley, Zager RA, Ryan MJ. Hypocalcemia: a pervasive metabolic abnormality in the critically ill. Am. J. Kidney Dis. 2001; 37: 689–698.

    Article  CAS  PubMed  Google Scholar 

  35. Zaloga P. Hypocalcemia in critically ill patients. Crit. Care Med. 1992; 20: 251–262.

    Article  CAS  PubMed  Google Scholar 

  36. Kline CA, Esekogwu VI, Henderson SO, Newton KI. Non-convulsive status epilecticus in a patient with hypocalcemia. J. Emerg. Med. 1998; 16: 715–718.

    Article  CAS  PubMed  Google Scholar 

  37. Mundy GR, Martin TJ. The hypercalcemia of malignancy: pathogenesis and management. Metabolism 1982; 31: 1247–1277.

    Article  CAS  PubMed  Google Scholar 

  38. Tohme J, Bilezikian J. Critical illness and calcium metabolism. In Ober K, ed. Contemporary Endocrinology: Endocrinology of Critical Disease. Totowa, NJ: Humana Press, 1997: 233.

    Chapter  Google Scholar 

  39. Bilezikian J. Management of acute hypercalcemia. N. Engl. J. Med. 1992; 326: 1196.

    Article  CAS  PubMed  Google Scholar 

  40. Baran DT. Disorders of mineral metabolism. In Irwin RS, Cerra FB, Rippe JM, eds. Intensive Care Medicine, 4th ed. Philadelphia: Lippincott-Raven, 1999: 1283.

    Google Scholar 

  41. Hasling C, Charles P, Mosekilde L. Etidronate disodium in the management of malignancy-related hypercalcemia. Am. J. Med. 1987; 82: 51–54.

    Article  CAS  PubMed  Google Scholar 

  42. Bugg NC, Jones JA. Hypophosphatemia. Pathophysiology, effects and management on the intensive care unit. Anaesthesia 1998; 53: 895–902.

    Article  CAS  PubMed  Google Scholar 

  43. Riggs JE. Neurologic manifestations of fluid and electrolyte disturbances. Neurol. Clin. 1989; 7: 509–523.

    CAS  PubMed  Google Scholar 

  44. Agnelli G. Prevention of VTE after neurosurgery. Thromb. Haemost. 1999; 82: 925–930.

    CAS  PubMed  Google Scholar 

  45. Valladares JB, Hankinson J. Incidence of lower extremity deep vein thrombosis in neurosurgical patients. Neurosurgery 1980; 6: 138–141.

    Article  CAS  PubMed  Google Scholar 

  46. Ruff RL, Posner JB. Incidence and treatment of peripheral venous thrombosis in patients with glioma. Ann. Neurol. 1983; 13: 334–336.

    Article  CAS  PubMed  Google Scholar 

  47. Turpie AG, Hirsh J, Gent M. Prevention of deep venous thrombosis in potential neurosurgical patients: a randomized trial comparing graduated compresion stockings alone or graduated compresion stockings plus intermittent pneumatic compression with control. Arch. Intern. Med. 1989; 149: 679–681.

    Article  CAS  PubMed  Google Scholar 

  48. Macdonald RL, Amidei C, Lin G, et al. Safety of perioperative subcutaneous heparin for prophylaxis of VTE in patients undergoing craniotomy. Neurosurgery 1999; 45: 245–252.

    Article  CAS  PubMed  Google Scholar 

  49. Geerts W H, Heit JA, Clagett GP, et al. Prevention of venous thromboembolism. Chest 2001 119: 1325–1755.

    Article  Google Scholar 

  50. Mc Carthy ST, Turner JJ, Robertson D, et al. Low-dose heparin as prophylaxis against deep-vein thrombosis after acute ischemic stroke. Lancet 1977; 2: 800–801.

    Google Scholar 

  51. Bath PM, Iddenden R, Bath BJ. Low-molecular-weight heparins and heparinoids in acute ischemic stroke: a meta-analysis of randomized controlled trials. Stroke 2000; 35: 1770–1778.

    Article  Google Scholar 

  52. Kamran SI, Downey D, Ruff RI. Pneumatic sequential compression reduces the risk of deep venous thrombosis in stroke patients. Neurology 1998; 50: 1683–1688.

    Article  CAS  PubMed  Google Scholar 

  53. International stroke trial collaborative group. The international stroke trial (IST): a randomized trial of aspirin, subcutaneous heparin, both or neither among 19 435 patients with acute ischemic stroke. Lancet 1997; 349: 1569–1581.

    Article  Google Scholar 

  54. The publications committee for the trial of ORG 10172 in acute ischemic stroke treatment (TOAST) investigators. Low molecular weight heparinoid, ORG 10172 (danaparoid), and outcome after acute ischemic stroke; a randomized controlled trial. JAMA 1998; 279: 1265–1272.

    Google Scholar 

  55. Green D, Lee MY, Ito VY, et al. Fixed vs adjusted-dose heparin in the prophylaxis of thromboembolism in spinal cord injury. JAMA 1998; 260: 1255–1258.

    Google Scholar 

  56. Green D, Lee MY, Lim AC, et al. Prevention of thromboembolism after spinal cord injury using low-molecular-weight heparin. Ann. Intern. Med. 1990; 113: 571–574.

    CAS  PubMed  Google Scholar 

  57. Tapson VF, Carroll BA, Davidson BL, et al. The diagnostic approach to acute venous thromboembolism. Clinical practice guideline. American Thoracic Society. Am. J. Respir. Crit. Care Med. 1999; 160: 1043–1066.

    CAS  PubMed  Google Scholar 

  58. Ellis MH, Manor Y, Witz M. Risk factors and management of patients with upper limb deep vein trombosis. Chest 2000; 117: 43–46.

    Article  CAS  PubMed  Google Scholar 

  59. Inci S, Erbengi A, Berker M. Pulmonary embolism in neurosurgical patients. Surg. Neurol. 1995; 43: 123–128.

    Article  CAS  PubMed  Google Scholar 

  60. Goodman LR, Curtin JJ, Mewissen MW, et al. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. AJR 1995; 164: 1369–1374.

    CAS  PubMed  Google Scholar 

  61. Wet CJ, Pearl RG. Postoperative thrombotic complications. Anesth. Clin. North Am. 1999; 17: 895.

    Article  Google Scholar 

  62. Hausmann D, Schulte am EJ. The prognostic value of various intensive medicine parameters in long-term intubated neurosurgical patients. Anesthesie Intensivther. Notfallmed. 1982; 17: 139–144.

    Article  CAS  Google Scholar 

  63. Valli G, Fogazzi GB, Cappellari A, Rivolta E. Glomerulonephritis associated with myasthenia gravis. Am. J. Kid. Dis. 1998; 31: 350–355.

    Article  CAS  PubMed  Google Scholar 

  64. Khajehdehi P, Shariat A, Nikseresht A. Acute renal failure due to severe Landry-Guillain-Barre syndrome. Nephrol. Dialysis Trasplant. 1998; 13: 2388–2391.

    Article  CAS  Google Scholar 

  65. Britt CW Jr, Light RR, Peters BH, Schochet SS Jr. Rhabdomyolysis during treatment with epsilon-aminocaproic acid. Arch. Neurol. 1980; 37: 187–188.

    Article  PubMed  Google Scholar 

  66. Levy JB, Pusey CD. Nephrotoxicity of intravenous immunoglobulin. QJM 2000; 93: 751–755.

    Article  CAS  PubMed  Google Scholar 

  67. Briggs TB, Smith RR. Exertional rhabdomyolysis associated with decerebrate posturing. Neurosurgery 1986; 19: 279–299.

    Google Scholar 

  68. Davenport A. The management of renal failure in patients at risk of cerebral edema hypoxia. New Horiz. 1995; 3: 717–724.

    CAS  PubMed  Google Scholar 

  69. Caruso DM, Vishteh AG, Greene KA, Matthews MR, Carrion CA. Continous hemodialysis for the management of acute renal failure in the presence of cerebellar hemorrhage. J. Neurosurg. 1998; 89: 649–652.

    Article  CAS  PubMed  Google Scholar 

  70. Rabary O, Boussofara M, Grimaud D. Acid-base equilibrium and the brain. Ann. Fr. Anesth. Reanim. 1994; 13: 111–122.

    Article  CAS  PubMed  Google Scholar 

  71. Tallon-Barranco A, Ayuso-Peralta L, Jimenez-Jimenez, et al. Respiratory form of onset of motor neuron disease. Rev. Neurol. 2000; 30: 51–53.

    CAS  PubMed  Google Scholar 

  72. Huang R. Acid-base imbalance in acute cerebrovascular disease. Chung-Hua Shen Ching Ching Shen Ko Tsa Chih 1991;24:351–357,384.

    Google Scholar 

  73. Wijdicks EF, Hubmayr RD. Acute acid-base disorders associated with status epilecticus. Mayo Clin. Proc. 1994; 69: 1044–1046.

    Article  CAS  PubMed  Google Scholar 

  74. Chan KH, Mann KS, Lai EC, Ngan J, Tuen H, Yue CP. Factors influencing the development of gastrointestinal complications after neurosurgery: results of multivariate analysis. Neurosurgery 1989; 25: 378–382.

    Article  CAS  PubMed  Google Scholar 

  75. Lichtenstein DR, Berman MD, Wolfe MM. Approach to the patient with acute upper gastrointestinal hemorrhage. In Taylor MB, Gollan JL, Steer ML eds. Gastrointestinal Emergencies, 2nd ed. Baltimore: Williams Wilkins, 1997: 99–129.

    Google Scholar 

  76. Fadul CE, Lemann W, Thaler HT, Posner JB. Perforation of the gastrointestinal tract in patients receiving steroids for neurological disease. Neurology 1988; 38: 348–352.

    Article  CAS  PubMed  Google Scholar 

  77. Inayet N, Amoateng-Adjepong Y, Upadya A, Manthous CA. Risks for developing critical illness with GI hemorrhage. Chest 2000; 118: 473–478.

    Article  CAS  PubMed  Google Scholar 

  78. Miller TA, Tornwall MS, Moody FG: Stress erosive gastritis. Curr. Probl. Surg. 1991; 28: 459–509.

    Article  Google Scholar 

  79. Miller TA: Mechanisms of stress-related mucosal damage. Am. J. Med. 1987; 83 (suppl 6A): 8–14.

    Article  CAS  PubMed  Google Scholar 

  80. McGuirk TD, Coyle WJ. Upper gastrointestinal tract bleeding. Emerg. Med. Clin. North Am. 1996; 14: 523–545.

    Article  CAS  PubMed  Google Scholar 

  81. Cappell MS. A study of the syndrome of simultaneous acute upper gastrointestinal bleeding and myocardial infarction in 36 patients. Am. J. Gastroenterol. 1995; 90: 1444–1449.

    CAS  PubMed  Google Scholar 

  82. Cuellar RE, Gavaler JS, Alexander JA, Brouiellette DE, Chien MC, Yoo KC. Gastrointestinal tract hemorrhage: the value of a nasogastric aspirate. Arch Intern Med 1990; 150: 1381–1384.

    Article  CAS  PubMed  Google Scholar 

  83. Kankaria AG, Fleischer DE. The critical care management of nonvariceal upper gastrointestinal bleeding. Crit. Care Clin. 1995; 11: 347–368.

    CAS  PubMed  Google Scholar 

  84. Shetty HG, Backhouse G, Bentley DP, Routledge PA. Effective reversal of warfarin-induced excessive anticoagulation with low dose vitamin K1. Thromb. Haemost. 1992; 67: 13–15.

    CAS  PubMed  Google Scholar 

  85. George JN, Shattil SJ: The clinical importance of acquired abnormalities of platelet function. N. Engl. J. Med. 1991; 324: 27–39.

    Article  CAS  PubMed  Google Scholar 

  86. Lu WY, Rhoney DH, Boling WB, Johnson JD, Smith TC. A review of stress ulcer prophylaxis in the neurosurgical intensive cares unit. Neurosurgery 1997; 41: 416–425.

    Article  CAS  PubMed  Google Scholar 

  87. Tryba M, Cook D. Current guidelines on stress ulcer prophylaxis. Drugs 1997; 54: 581–596.

    Article  CAS  PubMed  Google Scholar 

  88. Lau JY, Sung JJ, Lee KK, et al. Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers. N. Engl. J. Med. 2000; 343: 310–316.

    Article  CAS  PubMed  Google Scholar 

  89. Fenton WJ, Ofosu FA, Brezniak DV. Understanding Thrombin and hemostasis. Hematol. Oncol. Clin. North Am. 1993; 7: 1107–1119.

    PubMed  Google Scholar 

  90. Jenny NS, Mann KG. Coagulation cascade: an overview. In Loscalzo J, Schafer AI, eds. Thrombosis and Hemorrhage. Baltimore: Williams Wilkins, 1998: 3.

    Google Scholar 

  91. Wardlaw JM. Overview of Cochrane thrombolysis meta-analysis. Neurology 2001; 57 (5 Suppl 2): S69–S76.

    Article  CAS  PubMed  Google Scholar 

  92. Gebel JM, Broderick JP. Intracerebral hemorrhage. Neurol. Clin. 2000; 18: 419–438.

    Article  CAS  PubMed  Google Scholar 

  93. Owings JT, Gosselin R. Acquired antithrombin deficiency following severe traumatic injury: rationale for study of antithrombin supplementation. Semin. Thromb. Hemost. 1997; 23 (suppl 1): 17–24.

    Article  PubMed  Google Scholar 

  94. Gando S, Tedo l, Kubota M. Posttrauma coagulation and fibrinolysis. Crit. Care Med. 1992; 20: 594–600.

    Article  CAS  PubMed  Google Scholar 

  95. Miller RS, Weatherford DA, Stein D, Crane MM, Stein M. Antithrombin III and trauma patients: factors that determine low levels. J Trauma 1994; 37: 442–445.

    Article  CAS  PubMed  Google Scholar 

  96. Gando S, Nakanishi Y, Tedo I. Cytokines and plasminogen activator inhibitor-1 in posttrauma disseminated intravascular coagulation: relationship to multiple organ dysfunction syndrome. Crit. Care Med. 1995; 20: 1835–1842.

    Article  Google Scholar 

  97. Kearney TJ, Bento L, Grode M. Coagulopathy and catecholamines in severe head injury. J. Trauma 1992; 32: 608–611.

    Article  CAS  PubMed  Google Scholar 

  98. Counts RB, Haisch C, Simon TL, Maxwell NG, Heimbach DM, Carrico CJ. Hemostasis in massively transfused trauma patients. Ann. Surg. 1979; 190: 91–99.

    Article  CAS  PubMed  Google Scholar 

  99. Phillips TF, Soulier G, Wilson RF. Outcome of massive transfusion exceeding two blood volumes in trauma and emergency surgery. J. Trauma 1987; 27: 903–910.

    Article  CAS  PubMed  Google Scholar 

  100. Martin DJ, Lucas CE, Ledgerwood AM, Hoschner J, McGorrigal MD, Grabow D. Fresh frozen plasma supplement to massive red blood cell transfusion. Ann. Surg. 1985; 202: 505–511.

    Article  CAS  PubMed  Google Scholar 

  101. Redd RL 2nd, Ciavarella D, Heimbach DM, et al. Prophylactic platelet administration during massive transfusion. Ann. Surg. 1986; 203: 40–48.

    Article  Google Scholar 

  102. Watts DD, Trask A, Soeken K, Perdue P, Dols S, Kaufmann C. Hypothermic coagulopathy in trauma: effect of varying levels of hypothermia on enzyme speed, platelet function, and fibrinolytic activity. J. Trauma 1998; 44: 846–854.

    Article  CAS  PubMed  Google Scholar 

  103. Reed RL 2nd, Bracey AW Jr, Hudson JD, Miller TA, Fischer RP. Hypothermia and blood coagulation: dissociation between enzyme activity and clotting factor levels. Circ. Shock 1990; 32: 141–152.

    PubMed  Google Scholar 

  104. Luna GK, Maier RV, Pavlin EG, Anardi D, Copass MK. Incidence and effect of hypothermia in seriously injured patients. J. Trauma 1987; 27: 1014–1018.

    Article  CAS  PubMed  Google Scholar 

  105. Patt A, McCroskey B, Moore E. Hypothermia induced coagulopathies in trauma. Surg. Clin. North Am. 1988; 68: 775–785.

    CAS  PubMed  Google Scholar 

  106. Dhainaut JF. Introduction to the Margaux conference on critical illness: activation of the coagulation system in critical illnesses. Crit. Care Med. 2000; 28 (9 Suppl): S1–S3.

    Article  CAS  PubMed  Google Scholar 

  107. Harrigan C, Lucas CE, Ledgerwood AM, et al. The effect of hemorrhagic shock on the clotting cascade in injured patients. J. Trauma 1989; 29: 1416–1421.

    Article  CAS  PubMed  Google Scholar 

  108. Verstraete M. Clinical application of inhibitors of fibrinolysis. Drugs 1995; 29: 236–261.

    Article  Google Scholar 

  109. Dunn CJ, Goa KL. Tranexamic acid: a review of its use in surgery and other indications. Drugs 1999; 57: 1005–1032.

    Article  CAS  PubMed  Google Scholar 

  110. Dettenkofer M, Ebner W, Hans FJ, et al. Nosocomial infections in a neurosurgery intensive care unit. Acta. Neurochir. 1999; 141: 1303–1308.

    Article  CAS  PubMed  Google Scholar 

  111. Pratt RJ, Pellowe C, Loveday HP, et al. The epic project: developing national evidence-based guidelines for preventing healthcare associated infections. Phase I: guidelines for preventing hospital-acquired infections. J. Hosp. Infect. 2001; 47: S3–S82.

    Article  PubMed  Google Scholar 

  112. Paramore CG, Turner DA. Relative risk of ventriculostomy infection and morbidity. Acta. Neurochir. (Wien) 1994; 127: 79–84.

    Article  CAS  Google Scholar 

  113. Khan SH, Kureshi IU, Mulgrew T, Ho SY, Onnyiuke HC. Comparison of percutaneous ventriculostomies and intraparenchymal monitor: a retrospective evaluation of 156 patients. Acta. Neurochir. (Wien) 1998; 71: 50–52.

    CAS  Google Scholar 

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  1. Jose L. Diaz
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  2. Marcela Granados
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  3. Jose I. Suarez
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Editors and Affiliations

  1. Neurosciences Critical Care, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH, USA

    Jose I. Suarez MD

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Diaz, J.L., Granados, M., Suarez, J.I. (2004). Management of Medical Complications in the Neurosciences Critical Care Unit. In: Suarez, J.I. (eds) Critical Care Neurology and Neurosurgery. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-660-7_11

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  • DOI: https://doi.org/10.1007/978-1-59259-660-7_11

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