Neurocritical Care Society Podcast

In this episode of Hot Topics, Dr. Nicholas Morris interviews Dr. David Greer, a leading expert in brain death determination, to discuss the Neurocritical Care Society's new in-person brain death determination course. Dr. Greer highlights the importance of standardized protocols and training, the global success of the online course and the advantages of hands-on learning with mannequins and expert supervision. They also explore common errors in brain death exams and the need for rigorous certification to ensure accuracy and consistency in clinical practice. Learn more and register for the in-person Brain Death Determination Course here. Tune in to discover how this course is revolutionizing brain death determination worldwide. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of Perspectives, Dr. Nicholas Morris talks with Diane McLaughlin, FNCS, about her journey into neurocritical care and the vital role of postgraduate training for APPs. She highlights the importance of ultrasound, sharing how she developed her skills and discusses strategies for staff retention and career growth. She also reflects on advancements in stroke treatment and the benefits of professional society involvement. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of Hot Topics, Dr. Nicholas Morris interviews Claire Dahyot-Fizelier, M.D, Ph.D., a professor of anesthesia and intensive care at the University of Poitiers, to explore the groundbreaking PROPHY-VAP trial published in The Lancet Respiratory Medicine. This landmark study investigates the impact of single-dose ceftriaxone prophylaxis on ventilator-associated pneumonia (VAP) in acute brain injury patients. Dr. Dahyot-Fizelier discusses the rationale behind the study, key findings and the broader implications for ICU practices. Tune in to discover how this trial could reshape approaches to infection prevention and improve patient outcomes in neurocritical care. Show notes: https://doi.org/10.1016/S2213-2600(23)00471-X Dahyot-Fizelier C, Lasocki S, Kerforne T, Perrigault PF, Geeraerts T, Asehnoune K, Cinotti R, Launey Y, Cottenceau V, Laffon M, Gaillard T, Boisson M, Aleyrat C, Frasca D, Mimoz O, on behalf of the PROPHY-VAP Study Group and the ATLANREA Study Group. Ceftriaxone to prevent early ventilator-associated pneumonia in patients with acute brain injury: a multicentre, randomised, double-blind, placebo-controlled, assessor-masked superiority trial. The Lancet Respiratory Medicine. 2024 May 1;12(5):375-85. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

Giuseppe Saterio, a professor of anesthesia and intensive care at Milano-Bicocca University, discusses groundbreaking findings from the ORANGE study on the Neurological Pupil Index (NPI). He explains how abnormal NPI values can predict outcomes in acute brain injury patients. Despite hopes, the study revealed no strong correlation between NPI and intracranial pressure. Saterio emphasizes the significance of regular pupil assessments and the need for standardized responses to low NPI values, paving the way for improved neurocritical care practices.

On September 2022, Cameron Kuklick fell from a motorized rental scooter while returning to his hotel after celebrating his brother's wedding in Harrisonburg, Virginia. Cameron experienced a severe traumatic brain injury (TBI) at the age of 30. Cameron and his family hope that by sharing their story and experiences, they too can provide hope and healing for others. In this week's episode, Cameron joins Dr. Lauren Koffman and Dea Mahanes, DNP, APRN, CCNS, HEC-C, FNCS, who was on Cameron's care team, to discuss his Story of Hope. You can read Cameron's story in Currents at https://currents.neurocriticalcare.org/Stories-of-Hope/Article/unbroken-stride-camerons-story-of-hope-overcoming-brain-injury-to-cross-the-finish-line. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this week's episode of Perspectives, Dr Nicholas Morris is joined by NCS Past President, Dr Gretchen Brophy, Professor of Pharmacotherapy & Outcomes Sciences and Neurosurgery with Virginia Commonwealth University (VCU) School of Pharmacy, Medical College of Virginia Campus, in Richmond.

Electroencephalography (EEG) is an important and relatively inexpensive tool that allows intensivists to monitor cerebral activity of critically ill patients in real time. Seizure detection in patients with and without acute brain injury is the primary reason to obtain an EEG in the Intensive Care Unit (ICU); and in response to the increased demand for EEG, advances in quantitative EEG (qEEG) created an approach to review large amounts of data instantly. Today, rapid response EEG is now available to reduce the time to detect electrographic seizures in limited-resource settings. In this week's MasterClass, our hosts Dr Jon Rosenberg and Dr Stephan Mayer are joined by Dr Lawerence Hirsch, Co-Director of the Critical Care EEG Monitoring Program at Yale School of Medicine to discuss the evolution, value, and impact of brain monitoring with EEG in the critically ill.

The purpose of informed consent, as it exists now, is primarily to maintain patient autonomy, but additional benefits include the protection of patients, avoidance of fraud, and promotion of rational decisions, amongst others. It is now considered both an ethical and legal obligation which should, at a minimum, always include: 1) the nature of the procedure, 2) the risks and benefits of the procedure, 3) reasonable alternatives, and 4) risks and benefits of alternatives, with an assessment of comprehension of these elements (1). This week Dr Lauren Koffman is joined by Clotilde Balucani, MD and Julia Durrant, MD two of the authors of the recent Currents article Consent for Brain Death Determination - the ends justify the means... or it does not.

Dr. Nicholas Morris is joined by Prof. Jürgen Beck and Prof. Urs Fischer to discuss the SWITCH trial on decompressive craniectomy for deep intracerebral hemorrhage. They cover trial outcomes, analysis of secondary outcomes, serious adverse events, and advancements in intracerebral hemorrhage care.

Ashkan Shoamanesh discusses the ANNEXA-I Trial's impact on hematoma volume expansion in intracerebral hemorrhage patients on Factor Xa inhibitors. Topics include challenges in reversing effects, trial design, safety analyses, and clinical outcomes.