The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Monitoring methods following severe head injury currently use indirect measurements of cerebral oxygenation and perfusion defined as intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring. Adequate information regarding cerebral blood flow and oxygenation is necessary to guide treatment and prevent secondary cerebral ischemia. Because of the ineffectiveness of ICP and CPP monitoring in detecting early ischemic changes in healthy, as well as compromised, brain tissue, patients' neurological outcome and recovery may be less than optimal. ⋯ This unique combination helps reflect early changes in brain tissue viability. As with any new monitoring device, there are associated advantages and disadvantages as well as cost issues, to consider. Patients with head injuries can benefit from technology that guides decisions and prevents treatment delays.
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Intrathecal baclofen (ITB) therapy has evolved into a standard treatment for severe spasticity. After this therapy had been provided for 10 years, a retrospective chart review on 50 patients, representing a total 2,922 patient months of ITB service, was done. ⋯ Pump refills occurred every 3 months for 58% of the group. Three evolving trends in ITB therapy were identified from clinical trial to current management: (a) higher catheter tip placement, (b) use of more complex infusion modes, and (c) a decreased complication rate.