Neurosurgery
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Whole blood (WB) transfusion in trauma has been revisited, and recent studies have reported an association between WB and improved survival among patients with hemorrhagic shock. However, no evidence of a similar association exists for patients with hemorrhagic shock and traumatic brain injury (TBI). This study aimed to assess the association between WB and mortality among patients with hemorrhagic shock and TBI. ⋯ WB was not associated with reduced 30-day mortality among patients with hemorrhagic shock and TBI. These findings suggest that not all patients with hemorrhagic shock would benefit from WB.
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This study assessed feasibility, radiologic parameters, and clinical outcomes in patients who underwent the prone transpsoas (PTP) approach for lateral lumbar interbody fusion. ⋯ In this single-institution patient series, the PTP approach was effective and safe for lateral lumbar fusion, with minimal complications and improved lumbar lordosis and patient-reported pain outcomes.
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Intraventricular drug delivery enables the delivery of therapeutics to the central nervous system, while minimizing peripheral drug exposure and toxicity. However, currently used delivery devices cannot be controlled externally to adjust their output during delivery. Here, the authors investigated the performance of a conceptually novel device designed to metronomically deliver a drug to the cerebrospinal fluid in a manner that can be adjusted wirelessly from an external controller. ⋯ This implantable pump system enables external control of drug output, so that the resulting intraventricular drug concentrations can continuously be maintained within the therapeutic range.