Neurocritical Care Society Podcast

In this week's episode of Perspectives, Dr Nicholas Morris is joined by Dr Monisha Kumar, FNCS, Professor of Neurology at the Hospital of the University of Pennsylvania to discuss the threats to diversity, equity, and inclusion in neurocritical care.

As clinicians working with patients who have sustained an acute brain injury, we are naturally focused on caring for the injury itself. Until recent years, the clinical severity of brain injury was regarded as the main driver of prognosis and outcomes. However, we are beginning to understand how non-clinical factors, including the social determinants of health (SDOH), contribute to differential risk for all brain injuries including hemorrhagic stroke, and continue to impact our patients' recovery even after injury. In this week's episode Dr Lauren Koffman is joined by Dr Nirupama Yechoor and Dr Rachel Forman to discuss how understanding the complex interplay between clinical and social determinants of health is crucial for clinicians caring for hemorrhagic stroke survivors, not only for recovery and secondary prevention, but also to effectively counsel families on primary prevention. Lauren is also joined by Mike Foster, a member of Yale's Stroke Patient Advisory Board who talks about his experience as a stroke survivor. You can read the Currents article at https://currents.neurocriticalcare.org/Leading-Insights/Article/innovation-for-health-disparities-research-in-hemorrhagic-stroke. Stroke survivors or those who care for loved ones who have had a stroke can sign-up for Dr Yechoor's study at https://rally.massgeneralbrigham.org/study/strokewellbeing.

Dr Jennifer Frontera discusses NCS Guidelines for Seizure Prophylaxis in TBI patients, focusing on challenges with seizure medications, inclusion criteria, and exploring different anti-seizure medications like phenytoin and levetiracetam. The discussion also includes guideline recommendation methodology, the role of Bayesian meta-analysis, and the effectiveness of anti-seizure medications in preventing seizures in adults with TBI.

In this week's PERSPECTIVES episode, Dr Nicholas Morris is joined by Dr Daryl Gress, Professor of Neurological Sciences at the University of Nebraska to discuss Dr Gress' lessons learned while building a new neurocritical care unit and training program at UCSF.

Post-intensive care clinics following admission to the intensive care unit (ICU) have gained significant traction in recent years across the United States and internationally. This movement has been driven by increasing recognition of the long-term sequela related to the experience of an ICU admission. This week, Dr Lauren Koffman is joined by Dr Matthew Jaffa and Dr Julia Carlson to discuss the landscape of post-neuroICU clinics and the impetus for their development and continuation.

In May 2014 Elisabeth Beraquit fell through the faulty doors of an elevator into an empty shaft, landing 30 feet below on top of the elevator car. She suffered multiple traumatic brain injuries, including subarachnoid hemorrhage, intraventricular hemorrhage, and a diffuse axonal injury. 10 years on and Elisabeth is thriving, running her own business in Philadelphia and living her best life. In this week's episode she and her sister, Sarah, join Dr Lauren Koffman to discuss Elisabeth's Story of Hope. You can read Elisabeth's story in Currents at https://currents.neurocriticalcare.org/Stories-of-Hope/Article/story-of-hope-elisabeth.

Experts Dr. Karen Hirsch and Dr. Teresa May discuss critical care management of post-arrest patients. They explore scientific statements vs guidelines, research priorities, and personalized treatment strategies for ICU patients. Topics include consensus on management statements, individualized care, sedation challenges, and the need for further research.

This week's Hot Topic is Intravenous Levothyroxine for Unstable Brain-Dead Heart Donors and Dr Nicholas Morris is joined by Dr Raj Dhar from Washington University School of Medicine to discuss his latest New England Journal of Medicine manuscript (https://pubmed.ncbi.nlm.nih.gov/38048188/).

Dr Krishna Rajajee joins to discuss non-invasive intracranial pressure monitoring. Topics include comparing non-invasive methods with invasive monitoring, drawbacks of optic nerve sheath diameter measurement, and role of pupilometry in assessing elevated ICP.

Dr. Jose Suarez discusses the NCS subarachnoid hemorrhage guidelines, comparing them with AHA guidelines and highlighting the importance of guidelines in research priorities and healthcare practices. Topics include challenges in guideline development, balancing guidelines with clinical judgment, personalized medicine, and research-based approaches in neurocritical care.