The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
David M Greer - One of the best experts on this subject based on the ideXlab platform.
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abstract 416 four score remains effective prognostic tool in cardiac arrest after eliminating respiratory component
Circulation, 2019Co-Authors: Jonathan Duskin, Stephanie Liang, Katie Dam, William Spears, Kushak Suchdev, David M GreerAbstract:Introduction: The FOUR (Full Outline of UnResponsiveness) score was developed as a more effective alternative to the Glasgow Coma Scale for Prognostication of critically-ill neurology patients. Cur...
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Gap Analysis Regarding Prognostication in Neurocritical Care: A Joint Statement from the German Neurocritical Care Society and the Neurocritical Care Society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, J. Claude HemphillAbstract:Background/Objective Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. Methods As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Würzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barré Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Results Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Conclusions Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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gap analysis regarding Prognostication in neurocritical care a joint statement from the german neurocritical care society and the neurocritical care society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, Claude J HemphillAbstract:Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Wurzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barre Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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neuroimaging in cardiac arrest Prognostication
Seminars in Neurology, 2017Co-Authors: David M GreerAbstract:Neuroimaging is commonly utilized in the evaluation of post-cardiac arrest patients, providing a unique ability to visualize and quantify structural brain injury that can complement clinical and electrophysiologic data. Despite its lack of validation, we would advocate that neuroimaging is a valuable Prognostication tool, worthy of further study, and an essential part of the armamentarium when used in combination with other modalities in the assessment of the post-cardiac arrest patient. Herein, we discuss the data and its limitations for neuroimaging to date and how it is being studied prospectively. We present current guidelines recommendations for Prognostication after global hypoxic-ischemic injury, focusing primarily on computed tomography (CT) and magnetic resonance imaging (MRI), as they are the most widely used modalities. We present promising results from advanced neuroimaging techniques, and provide practical advice for the clinician caring for these patients in the real world.
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clinical examination for Prognostication in comatose cardiac arrest patients
Resuscitation, 2013Co-Authors: David M Greer, Jingyun Yang, Patricia D Scripko, John R Sims, Sydney S Cash, Jason P Hafler, David A Schoenfeld, Karen L FurieAbstract:Objective To build new algorithms for Prognostication of comatose cardiac arrest patients using clinical examination, and investigate whether therapeutic hypothermia influences the value of the clinical examination.
Alejandro A. Rabinstein - One of the best experts on this subject based on the ideXlab platform.
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Gap Analysis Regarding Prognostication in Neurocritical Care: A Joint Statement from the German Neurocritical Care Society and the Neurocritical Care Society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, J. Claude HemphillAbstract:Background/Objective Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. Methods As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Würzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barré Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Results Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Conclusions Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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gap analysis regarding Prognostication in neurocritical care a joint statement from the german neurocritical care society and the neurocritical care society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, Claude J HemphillAbstract:Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Wurzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barre Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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neurological Prognostication after cardiac arrest in the era of target temperature management
Current Neurology and Neuroscience Reports, 2019Co-Authors: Maximiliano A. Hawkes, Alejandro A. RabinsteinAbstract:The purpose of this study is to provide an updated review on neurological Prognostication in comatose patients after cardiac arrest in light of current targeted temperature management (TTM) strategies. With improved pre-hospital and hospital care, death due to cardiac arrest is decreasing. Yet, most survivors have poor neurological outcomes. While TTM has demonstrated to improve neurological outcomes, it may cloud our prognostic accuracy. A multimodal approach is currently used to diminish prognostic uncertainty. The neurological examination remains the mainstay for prognosis after cardiac arrest. The combination electroencephalogram, somatosensory evoked potentials, and neuron-specific enolase improve prognostic accuracy, mostly in patients who underwent TTM. Quantitative analysis of pupillary reaction and EEG background variability, neuroimaging (CT perfusion and DWI-MRI), and middle/long-latency evoked potentials are promising methods that may further improve the precision of outcome Prognostication.
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neurological Prognostication of outcome in patients in coma after cardiac arrest
Lancet Neurology, 2016Co-Authors: Andrea O Rossetti, Alejandro A. Rabinstein, Mauro OddoAbstract:Management of coma after cardiac arrest has improved during the past decade, allowing an increasing proportion of patients to survive, thus Prognostication has become an integral part of post-resuscitation care. Neurologists are increasingly confronted with raised expectations of next of kin and the necessity to provide early predictions of long-term prognosis. During the past decade, as technology and clinical evidence have evolved, post-cardiac arrest Prognostication has moved towards a multimodal paradigm combining clinical examination with additional methods, consisting of electrophysiology, blood biomarkers, and brain imaging, to optimise prognostic accuracy. Prognostication should never be based on a single indicator; although some variables have very low false positive rates for poor outcome, multimodal assessment provides resassurance about the reliability of a prognostic estimate by offering concordant evidence.
Katja E Wartenberg - One of the best experts on this subject based on the ideXlab platform.
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gap analysis regarding Prognostication in neurocritical care a joint statement from the german neurocritical care society and the neurocritical care society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, Claude J HemphillAbstract:Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Wurzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barre Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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Gap Analysis Regarding Prognostication in Neurocritical Care: A Joint Statement from the German Neurocritical Care Society and the Neurocritical Care Society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, J. Claude HemphillAbstract:Background/Objective Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. Methods As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Würzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barré Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Results Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Conclusions Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
Susanne Muehlschlegel - One of the best experts on this subject based on the ideXlab platform.
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gap analysis regarding Prognostication in neurocritical care a joint statement from the german neurocritical care society and the neurocritical care society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, Claude J HemphillAbstract:Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Wurzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barre Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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Gap Analysis Regarding Prognostication in Neurocritical Care: A Joint Statement from the German Neurocritical Care Society and the Neurocritical Care Society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, J. Claude HemphillAbstract:Background/Objective Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. Methods As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Würzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barré Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Results Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Conclusions Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
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what families need and physicians deliver contrasting communication preferences between surrogate decision makers and physicians during outcome Prognostication in critically ill tbi patients
Neurocritical Care, 2017Co-Authors: Thomas Quinn, Jesse Moskowitz, Muhammad A Khan, Lori Shutter, Robert J Goldberg, Nananda F Col, Kathleen M Mazor, Susanne MuehlschlegelAbstract:Surrogate decision-makers (“surrogates”) and physicians of incapacitated patients have different views of prognosis and how it should be communicated, but this has not been investigated in neurocritically ill patients. We examined surrogates’ communication preferences and physicians’ practices during the outcome Prognostication for critically ill traumatic brain injury (ciTBI) patients in two level-1 trauma centers and seven academic medical centers in the USA. We used qualitative content analysis and descriptive statistics of transcribed interviews to identify themes in surrogates (n = 16) and physicians (n = 20). The majority of surrogates (82%) preferred numeric estimates describing the patient’s prognosis, as they felt it would increase prognostic certainty, and limit the uncertainty perceived as frustrating. Conversely, 75% of the physicians reported intentionally omitting numeric estimates during Prognostication meetings due to low confidence in family members’ abilities to appropriately interpret probabilities, worry about creating false hope, and distrust in the accuracy and data quality of existing TBI outcome models. Physicians felt that these models are for research only and should not be applied to individual patients. Surrogates valued compassion during Prognostication discussions, and acceptance of their goals-of-care decision by clinicians. Physicians and surrogates agreed on avoiding false hope. We identified fundamental differences in the communication preferences of prognostic information between ciTBI patient surrogates and physicians. These findings inform the content of a future decision aid for goals-of-care discussions in ciTBI patients. If validated, these findings may have important implications for improving communication practices in the neurointensive care unit independent of whether a formal decision aid is used.
Claude J Hemphill - One of the best experts on this subject based on the ideXlab platform.
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gap analysis regarding Prognostication in neurocritical care a joint statement from the german neurocritical care society and the neurocritical care society
Neurocritical Care, 2019Co-Authors: Katja E Wartenberg, Alejandro A. Rabinstein, David M Greer, David Y Hwang, Karl Georg Haeusler, Susanne Muehlschlegel, Oliver W Sakowitz, Dominik Madžar, Hajo M Hamer, Claude J HemphillAbstract:Prognostication is a routine part of the delivery of neurocritical care for most patients with acute neurocritical illnesses. Numerous prognostic models exist for many different conditions. However, there are concerns about significant gaps in knowledge regarding optimal methods of Prognostication. As part of the Arbeitstagung NeuroIntensivMedizin meeting in February 2018 in Wurzburg, Germany, a joint session on Prognostication was held between the German NeuroIntensive Care Society and the Neurocritical Care Society. The purpose of this session was to provide presentations and open discussion regarding existing prognostic models for eight common neurocritical care conditions (aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, acute ischemic stroke, traumatic brain injury, traumatic spinal cord injury, status epilepticus, Guillain–Barre Syndrome, and global cerebral ischemia from cardiac arrest). The goal was to develop a qualitative gap analysis regarding Prognostication that could help inform a future framework for clinical studies and guidelines. Prognostic models exist for all of the conditions presented. However, there are significant gaps in Prognostication in each condition. Furthermore, several themes emerged that crossed across several or all diseases presented. Specifically, the self-fulfilling prophecy, lack of accounting for medical comorbidities, and absence of integration of in-hospital care parameters were identified as major gaps in most prognostic models. Prognostication in neurocritical care is important, and current prognostic models are limited. This gap analysis provides a summary assessment of issues that could be addressed in future studies and evidence-based guidelines in order to improve the process of Prognostication.
