SAGE open medicine
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It remains uncertain whether nonconvulsive seizures and nonconvulsive status epilepticus in pediatric traumatic brain injury are deleterious to the brain and/or impact the recovery from injury. Consequently, optimal electroencephalographic surveillance and management is unknown. We aimed to determine specialists' opinion regarding the detection and treatment of nonconvulsive seizures or nonconvulsive status epilepticus in pediatric traumatic brain injury, regardless of their practice. ⋯ The Canadian specialists' opinion is that nonconvulsive seizures and nonconvulsive status epilepticus are biomarkers of brain injury and contribute to worsened outcomes. This suggests the urgency of future outcome-oriented research in the identification and management of nonconvulsive seizures or nonconvulsive status epilepticus.
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Limited literature exists examining the use of enteral clonidine to transition patients from dexmedetomidine for management of agitation. The aim of this study was to evaluate dexmedetomidine discontinuation within 8 h of enteral clonidine administration in addition to the rates of dexmedetomidine re-initiation in patients who failed clonidine transition. ⋯ Enteral clonidine may be an effective and safe alternative to transition patients off of dexmedetomidine for ongoing sedation management. Clinicians should critically evaluate the need for clonidine at ICU and hospital discharge. More studies comparing the use of clonidine to transition from dexmedetomidine infusions are needed.
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This retrospective study was a comparative analysis of sensitivity of impulse oscillometry and spirometry techniques for use in a mixed chronic obstructive pulmonary disease group for assessing disease severity and inhalation therapy. ⋯ Impulse oscillometry parameters demonstrated greater sensitivity compared with spirometry for monitoring reversibility of airway obstruction and the effect of maintenance therapy. Impulse oscillometry may facilitate early treatment dose optimization and personalized medicine for chronic obstructive pulmonary disease patients.