The International journal of neuroscience
-
Increasing shortage of intensive care resources is a worldwide problem. While routine postoperative admission to the intensive care unit (ICU) of patients undergoing neurosurgery is a long established practice for many hospitals. Therefore, some neurosurgical patients have to be cared in post anesthesia care unit (PACU) before ICU admission during high ICU occupancy. ⋯ Average GCS on ICU discharge was higher in immediately admitted group (13.0 ± 3.5 vs. 11.4 ± 4.5, p = 0.012). However, delayed admission to ICU post neurosurgery was not associated with prolonged ICU length of stay, increased ICU mortality, increased postoperative complication and hospital/ICU cost (all p > 0.05). Thus, an algorithm for appropriate disposition of neurosurgical patients is warranted so as to balance the quality of care and control of scarce intensive resources.
-
The adoption of functional MRI for presurgical planning in neuro-oncology has been limited by the high degree of patient compliance required to generate accurate activation maps. The purpose of this work was to evaluate the brain activation properties and patient head motion associated with a presurgical fMRI cueing system utilizing complex scene and auditory commands to enhance compliance in patients with cognitive and physical deficits. ⋯ The fMRI cueing system using complex scene stimuli produced results comparable to a simple cueing system in target regions of the brain. In patients presenting with deficits that lead to noncompliance with fMRI procedures, the use of complex scene stimuli may provide a good alternative to conventional cueing methods.