Neurocritical Care Review Course-Q&A 2 with the Experts

Video Transcription

Video Summary

During a video session, several panelists discuss various topics related to neurocritical care. One question is asked about contraindications to targeted temperature management (TTM), and it is clarified that septic shock, pregnancy, and overdose may change the temperature that is chosen for TTM but are not absolute contraindications. Another question is asked about the target temperature for neurological exams to determine prognosis, and it is stated that knowing the guideline temperature targets of either 33°C or 36°C is probably sufficient for the exam. The panelists also discuss the use of hypertonic saline and mannitol for managing increased intracranial pressure (ICP), with hypertonic saline generally showing better outcomes. They mention the importance of maintaining a mean arterial pressure (MAP) goal of 70-90 mmHg if autoregulation is intact, and preventing a low CPP of less than 50 mmHg if autoregulation is impaired. The use of antithrombotics for stress-induced cardiomyopathy is also mentioned, with the evidence suggesting that short-term use may be beneficial. Finally, it is emphasized that the board exam questions will be based on clinical scenarios and guidelines, so controversial answers or ongoing debates should not be expected.

Asset Caption

Covers sessions: (1) ICP and Cerebral Edema Management, (2) Cerebral Hemodynamic Monitoring, (3) Neuromuscular Disease and Respiratory Failure, (4) Respiratory, (5) Cardiovascular I, (6) Cardiovascular II Shock and Hypertension, (7) Post‐Cardiac Arrest Care

Keywords

neurocritical care

targeted temperature management

contraindications

hypertonic saline

mannitol

autoregulation

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