Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
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Coagulopathy either from the use of anticoagulant, antiplatelet, or thrombolytic medications or from underlying medical conditions is considered one of the major risk factors for epidural hematoma formation related to epidural catheter placement or removal. The American Society of Regional Anesthesia and Pain Medicine (ASRA) has laid down guidelines regarding timing of neuraxial blockade or removal of neuraxial catheters in patients receiving either antithrombotic or thrombolytic therapy. ⋯ The epidural hematoma was diagnosed with an urgent magnetic resonance imaging, and the patient was urgently taken up for surgical evacuation of the hematoma. The patient made full recovery over 1 week period.
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Indian J Crit Care Med · Jul 2018
Neurological Prognostications for the Therapeutic Hypothermia among Comatose Survivors of Cardiac Arrest.
Currently, there are limited data of prognostic clues for neurological recovery in comatose survivors undergoing therapeutic hypothermia (TH). We aimed to evaluate clinical signs and findings that could predict neurological outcomes, and determine the optimal time for the prognostication. ⋯ Our study showed the simple neurological signs helped predict short-term neurological prognosis. The most reliable sign determining unfavorable outcome was the lack of PLR. The optimal time to assess prognosis was either at 48-72 h or 7 days after return of spontaneous circulation.