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Video Transcription

Video Summary

In this video, the speaker discusses three topics related to neurocritical care. The first topic is the timing of tracheostomy in patients with severe stroke. The speaker discusses a study that showed that early tracheostomy did not improve mortality or functional outcomes in these patients. However, another pilot study showed some encouraging results, with patients who received early tracheostomy having less sedation, better ventilation, and lower mortality rates. A larger trial was then conducted, comparing early tracheostomy to standard timing tracheostomy, but there was no difference in functional outcomes or mortality between the two groups. The second topic is epileptiform discharges in cardiac arrest survivors. The speaker discusses a study that found no difference in outcomes between a treatment group that aimed to suppress EEG discharges and a standard group that used sedatives. The speaker suggests using sedatives initially to stabilize patients and expediting tests that can provide more prognostic information. The final topic is fluid resuscitation in neuro ICU patients. The speaker discusses studies comparing balanced crystalloids to normal saline and finds that there is a trend towards better outcomes with balanced crystalloids in a mixed medical-surgical ICU population, particularly in patients with sepsis. However, the speaker notes that in brain-injured patients, especially those with traumatic brain injuries, there is a trend towards harm with balanced fluids. The speaker emphasizes the importance of individualizing fluid choices based on patient condition.

Asset Subtitle

Professional Development and Education, 2023

Asset Caption

Type: year in review | Year in Review: Neuroscience (SessionID 2000006)

Meta Tag

Content Type Presentation

Knowledge Area Professional Development and Education

Membership Level Professional

Membership Level Select

Tag Team Leadership

Tag Fellowship Training

Year 2023

Keywords

neurocritical care

tracheostomy timing

epileptiform discharges

fluid resuscitation

balanced crystalloids

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