Neurocritical Care Society Podcast – Details, episodes & analysis

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.

In this episode of Hot Topics, Dr. Nicholas Morris interviews Dr. Giuseppe Citerio, professor of anesthesia and intensive care at Milano-Bicocca University, about the ORANGE study, which investigated the neurological pupil index (NPI) for prognosticating outcomes in patients with acute brain injury. The study, involving 13 centers in Europe and North America, found that repeat abnormal NPI values, including zero, were predictors of poor outcomes. The study collected data every four hours for seven days and used a sophisticated statistical model to account for longitudinal changes. Despite initial expectations, the study did not find a strong correlation between the NPI and ICP, suggesting NPI should not be used as a surrogate for ICP. Future research may focus on developing a standardized response to low NPI values.

Show Notes:

https://doi.org/10.1016/S1474-4422(23)00271-5

Oddo M, Taccone FS, Petrosino M, Badenes R, Blandino-Ortiz A, Bouzat P, Caricato A, Chesnut RM, Feyling AC, Ben-Hamouda N, Hemphill JC. The Neurological Pupil index for outcome prognostication in people with acute brain injury (ORANGE): a prospective, observational, multicentre cohort study. The Lancet Neurology. 2023 Oct 1;22(10):925-33.

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.

For the latest episode in our Hot Topics series, Dr Nicholas Morris, FCNS is joined by Dr Jennifer Frontera, FNCS to discuss the NCS Guidelines for Seizure Prophylaxis in Adults Hospitalized with Moderate-Severe Traumatic Brain Injury. 

Download the guidelines at https://link.springer.com/article/10.1007/s12028-023-01907-x. 

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.

In this week's episode, Dr Nicholas Morris is joined by Dr. Karen Hirsch and Dr. Teresa May to discuss their paper “Critical Care Management of Patients After Cardiac Arrest: A Scientific Statement From the American Heart Association and Neurocritical Care Society”.  We discuss the difference between a scientific statement and a guideline, areas of uncertainty, and research priorities for the post-arrest patient.

You can read the paper at https://www.ahajournals.org/doi/10.1161/CIR.0000000000001163. 

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/). 

In this week's Master Class, Dr Stephan Mayer and Dr Jon Rosenberg are joined by Dr Krishna Rajajee to discuss non-invasive intracranial pressure monitoring

In this week's episode, Dr Nick Morris is joined by Dr Jose Suarez to discuss the recently updated NCS subarachnoid hemorrhage guidelines. We compare them with the recently released American Heart Association subarachnoid hemorrhage guideline; and we discuss the purpose of guidelines in general and how guidelines map out priorities for research.