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Article ; Online: Neurotrauma and Intracranial Pressure Management.

Bernard, Francis

2022 Volume 39, Issue 1, Page(s) 103–121

Abstract: Although intracranial pressure (ICP) monitoring has been the mainstay of traumatic brain injury (TBI) management for decades, new understanding of TBI physiopathology calls for paradigm shifts. The complexity of TBI management precludes ICP being taken ... ...

Abstract	Although intracranial pressure (ICP) monitoring has been the mainstay of traumatic brain injury (TBI) management for decades, new understanding of TBI physiopathology calls for paradigm shifts. The complexity of TBI management precludes ICP being taken as an isolated value with a specific threshold. Multimodality monitoring is crucial to expanding our comprehension of individualized pathophysiology, allowing for a precise and tailored treatment approach. This article will review keys concepts to interpret and apply published ICP management guidelines and statements.
MeSH term(s)	Humans ; Intracranial Pressure/physiology ; Brain Injuries, Traumatic/diagnosis ; Brain Injuries, Traumatic/therapy ; Monitoring, Physiologic
Language	English
Publishing date	2022-10-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1006423-0
ISSN	1557-8232 ; 0749-0704
ISSN (online)	1557-8232
ISSN	0749-0704
DOI	10.1016/j.ccc.2022.08.002
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Article ; Online: Monitoring patients with severe traumatic brain injury.

Diaz-Arrastia, Ramon / Bernard, Francis / Shutter, Lori / Barsan, William / Silbergleit, Robert

The Lancet. Neurology

2024 Volume 23, Issue 3, Page(s) 230–231

MeSH term(s)	Humans ; Brain Injuries, Traumatic ; Brain Injuries ; Monitoring, Physiologic
Language	English
Publishing date	2024-01-25
Publishing country	England
Document type	Letter
ZDB-ID	2081241-3
ISSN	1474-4465 ; 1474-4422
ISSN (online)	1474-4465
ISSN	1474-4422
DOI	10.1016/S1474-4422(24)00023-1
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Article ; Online: Tallulah Bankhead, Bette Davis, and Marc Blitzstein

Bernard Francis Dick

Journal of Arts and Humanities, Vol 4, Iss 01, Pp 19-

Lillian Hellman’s The Little Foxes as Play, Film, and Opera

2015 Volume 27

Abstract: While other American plays such as Elmer Rice’s Street Scene, Tennessee Williams’ A Streetcar Named Desire, and Eugene O’Neill’s Mourning Becomes Electra have made the journey from stage to film and finally to opera, the film and operatic versions were ... ...

Abstract	While other American plays such as Elmer Rice’s Street Scene, Tennessee Williams’ A Streetcar Named Desire, and Eugene O’Neill’s Mourning Becomes Electra have made the journey from stage to film and finally to opera, the film and operatic versions were faithful recreations of the original without the addition of new characters, including those from other works by the same playwright. Lillian Hellman’s best play, The Little Foxes (1939), is unusual in two respects: in the 1941 film version, a character is added who did not appear in the original in order to provide a love interest for the protagonist’s daughter, thereby resulting in a different ending; in the 1949 operatic version, a character from a later play by Hellman, Another Part of the Forest, is introduced to show how a young woman with romantic ideals evolved into the Lady Macbeth of American drama. Thus each version of The Little Foxes deepens our understanding of the original without altering the play’s dramatic impact.
Keywords	Forest ; Tallulah Bankhead ; Marc Blitzstein ; Bette Davis ; Lillian Hellman ; The Little Foxes ; William Wyler. ; History of scholarship and learning. The humanities ; AZ20-999 ; Social sciences (General) ; H1-99
Subject code	820
Language	English
Publishing date	2015-01-01T00:00:00Z
Publisher	MIR Center Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Brain Oxygen Optimization in Severe Traumatic Brain Injury (BOOST-3): a multicentre, randomised, blinded-endpoint, comparative effectiveness study of brain tissue oxygen and intracranial pressure monitoring versus intracranial pressure alone.

Bernard, Francis / Barsan, William / Diaz-Arrastia, Ramon / Merck, Lisa H / Yeatts, Sharon / Shutter, Lori A

BMJ open

2022 Volume 12, Issue 3, Page(s) e060188

Abstract: Introduction: Management of traumatic brain injury (TBI) includes invasive monitoring to prevent secondary brain injuries. Intracranial pressure (ICP) monitor is the main measurement used to that intent but cerebral hypoxia can occur despite normal ICP. ...

Abstract	Introduction: Management of traumatic brain injury (TBI) includes invasive monitoring to prevent secondary brain injuries. Intracranial pressure (ICP) monitor is the main measurement used to that intent but cerebral hypoxia can occur despite normal ICP. This study will assess whether the addition of a brain tissue oxygenation (PbtO Methods and analysis: Multicentre, randomised, blinded-endpoint comparative effectiveness study enrolling 1094 patients with severe TBI monitored with both ICP and PbtO Ethics and dissemination: This has been approved by Advarra Ethics Committee (Pro00030585). Results will be presented at scientific meetings and published in peer-reviewed publications. Trial registration number: ClinicalTrials.gov Registry (NCT03754114).
MeSH term(s)	Brain ; Brain Injuries, Traumatic/therapy ; Humans ; Intracranial Pressure ; Oxygen ; Quality of Life
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-03-10
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-060188
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Article ; Online: Sleep Disruptions in Hospitalized Adults Sustaining a Traumatic Brain Injury: A Scoping Review.

Leclerc, Catherine / Gervais, Charles / Hjeij, Danny / Briand, Marie-Michèle / Williamson, David / Bernard, Francis / Duclos, Catherine / Arbour, Caroline

The Journal of head trauma rehabilitation

2023

Abstract: Objective: Adults sustaining a traumatic brain injury (TBI) are at risk of sleep disturbances during their recovery, including when such an injury requires hospitalization. However, the sleep-wake profile, and internal and external factors that may ... ...

Abstract	Objective: Adults sustaining a traumatic brain injury (TBI) are at risk of sleep disturbances during their recovery, including when such an injury requires hospitalization. However, the sleep-wake profile, and internal and external factors that may interfere with sleep initiation/maintenance in hospitalized TBI patients are poorly understood. This review aimed to: (1) identify/summarize the existing evidence regarding sleep and sleep measurements in TBI adults receiving around-the-clock care in a hospital or during inpatient rehabilitation, and (2) identify internal/external factors linked to poor sleep in this context. Methods: A scoping review was conducted in accordance with the PRISMA Scoping Review Extension guidelines. A search was conducted in MEDLINE, PsycINFO, CINAHL, and Web of Science databases. Results: Thirty relevant studies were identified. The most common sleep variables that were put forth in the studies to characterize sleep during hospitalization were nighttime sleep time (mean = 6.5 hours; range: 5.2-8.9 hours), wake after sleep onset (87.1 minutes; range: 30.4-180 minutes), and sleep efficiency (mean = 72.9%; range: 33%-96%) using mainly actigraphy, polysomnography, and questionnaires (eg, the sleep-wake disturbance item of the Delirium Rating Scale or the Pittsburgh Sleep Quality Index). Twenty-four studies (80%) suggested that hospitalized TBI patients do not get sufficient nighttime sleep, based on the general recommendations for adults (7-9 hours per night). Sleep disruptions during hospitalization were found to be associated to several internal factors including TBI severity, cognitive status, and analgesia intake. External and modifiable factors, such as noise, light, and patient care, were consistently associated with sleep disruptions in this context. Conclusion: Although the literature on sleep disturbances in hospitalized TBI patients has been increasing in recent years, many gaps in knowledge remain, including phenotypes and risk factors. Identifying these factors could help clinicians better understand the multiple sources of TBI patients' sleep difficulties and intervene accordingly.
Language	English
Publishing date	2023-09-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	639221-0
ISSN	1550-509X ; 0885-9701
ISSN (online)	1550-509X
ISSN	0885-9701
DOI	10.1097/HTR.0000000000000899
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Article ; Online: Is it safe to initiate activity-based therapy within days following traumatic spinal cord injury? Preliminary results from the PROMPT-SCI trial.

Dionne, Antoine / Cavayas, Yiorgos Alexandros / Magnuson, David / Richard-Denis, Andréane / Petit, Yvan / Barthélémy, Dorothy / Bernard, Francis / Mac-Thiong, Jean-Marc

The journal of spinal cord medicine

2023 Volume 46, Issue 6, Page(s) 980–985

Abstract: Context: Activity-based therapy initiated within days of the accident could prevent complications and improve neurofunctional outcomes in patients with traumatic spinal cord injury (TSCI). However, it has never been attempted in humans with TSCI because ...

Abstract	Context: Activity-based therapy initiated within days of the accident could prevent complications and improve neurofunctional outcomes in patients with traumatic spinal cord injury (TSCI). However, it has never been attempted in humans with TSCI because of practical obstacles and potential safety concerns. The PROMPT-SCI trial is the first attempt at implementing ABT within the first days following a TSCI (i.e. very early ABT; VE-ABT). The objective is to determine if VE-ABT can be initiated safely in the intensive care unit (ICU) within 48 h of early decompressive surgery. Design: As part of the PROMPT-SCI trial, 15 adult patients with severe TSCI were enrolled between April and November of 2021. The intervention consisted of 30-minute sessions of motor-assisted in-bed leg cycling starting within 48 h of early spinal surgery. Safety was assessed through continuous monitoring of vital signs and recording of adverse events during and after sessions. The main outcome measure was the achievement (yes or no) of a full and safe session within 48 h of early surgery. Findings: Out of the 15 participants, 10 (66.6%) achieved this outcome. Out of the remaining 5, 2 were not cleared to engage in cycling within 48 h of surgery and 3 initiated cycling within 48 h but stopped prematurely. All 5 eventually completed a full and safe session within the next 1-2 days. In all 15 participants, there were no neurological deteriorations after the first completed session. Conclusion: Our results suggest that it is safe and feasible to perform a first session of VE-ABT within days of a severe TSCI with no serious adverse events and excellent completion rates.
MeSH term(s)	Adult ; Humans ; Neurosurgical Procedures/methods ; Outcome Assessment, Health Care ; Spinal Cord Injuries/complications ; Time Factors
Language	English
Publishing date	2023-08-02
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1223949-5
ISSN	2045-7723 ; 1079-0268
ISSN (online)	2045-7723
ISSN	1079-0268
DOI	10.1080/10790268.2023.2212329
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Article ; Online: Use of actigraphy for monitoring agitation and rest-activity cycles in patients with acute traumatic brain injury in the ICU.

Saavedra-Mitjans, Mar / Van der Maren, Solenne / Gosselin, Nadia / Duclos, Catherine / Frenette, Anne Julie / Arbour, Caroline / Burry, Lisa / Williams, Virginie / Bernard, Francis / Williamson, David R

Brain injury

2024 , Page(s) 1–7

Abstract: Background: In traumatic brain injury patients (TBI) admitted to the intensive care unit (ICU), agitation can lead to accidental removal of catheters, devices as well as self-extubation and falls. Actigraphy could be a potential tool to continuously ... ...

Abstract	Background: In traumatic brain injury patients (TBI) admitted to the intensive care unit (ICU), agitation can lead to accidental removal of catheters, devices as well as self-extubation and falls. Actigraphy could be a potential tool to continuously monitor agitation. The objectives of this study were to assess the feasibility of monitoring agitation with actigraphs and to compare activity levels in agitated and non-agitated critically ill TBI patients. Methods: Actigraphs were placed on patients' wrists; 24-hour monitoring was continued until ICU discharge or limitation of therapeutic efforts. Feasibility was assessed by actigraphy recording duration and missing activity count per day. Results: Data from 25 patients were analyzed. The mean number of completed day of actigraphy per patient was 6.5 ± 5.1. The mean missing activity count was 20.3 minutes (±81.7) per day. The mean level of activity measured by raw actigraphy counts per minute over 24 hours was higher in participants with agitation than without agitation. Conclusions: This study supports the feasibility of actigraphy use in TBI patients in the ICU. In the acute phase of TBI, agitated patients have higher levels of activity, confirming the potential of actigraphy to monitor agitation.
Language	English
Publishing date	2024-04-18
Publishing country	England
Document type	Journal Article
ZDB-ID	639115-1
ISSN	1362-301X ; 0269-9052
ISSN (online)	1362-301X
ISSN	0269-9052
DOI	10.1080/02699052.2024.2341323
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Article ; Online: Cognitive and Motor Function Effects of Antipsychotics in Traumatic Brain Injury: A Systematic Review of Pre-Clinical Studies.

Cataford, Gabrielle / Monton, Laurie-Anne / Karzon, Stephanie / Livernoche-Leduc, Camille / Saavedra-Mitjans, Mar / Potvin, Marie-Julie / Bernard, Francis / Burry, Lisa / Arbour, Caroline / Williamson, David R

Neurotrauma reports

2024 Volume 5, Issue 1, Page(s) 181–193

Abstract: Traumatic brain injury (TBI) survivors often suffer from agitated behaviors and will most likely receive pharmacological treatments. Choosing an optimal and safe treatment that will not interfere with neurological recovery remains controversial. By ... ...

Abstract	Traumatic brain injury (TBI) survivors often suffer from agitated behaviors and will most likely receive pharmacological treatments. Choosing an optimal and safe treatment that will not interfere with neurological recovery remains controversial. By interfering with dopaminergic circuits, antipsychotics may impede processes important to cognitive recovery. Despite their frequent use, there have been no large randomized controlled studies of antipsychotics for the management of agitated behaviors during the acute TBI recovery period. We conducted a systematic review and meta-analysis of pre-clinical studies evaluating the effects of antipsychotics post-TBI on both cognitive and motor recovery. MEDLINE and Embase databases were searched up to August 2, 2023. Pre-clinical studies evaluating the effects of antipsychotics on cognitive and motor functions post-TBI were considered. Risk of bias was evaluated with the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. We identified 15 studies including a total of 1188 rodents, mostly conducted in male Sprague-Dawley rats using cortical impact injury. The analysis revealed no consistent effect of haloperidol on motor functions, but risperidone was associated with a significant impairment in motor function on day 5 post-injury (7.05 sec; 95% confidence interval [CI]: 1.47, 12.62; I
Language	English
Publishing date	2024-03-05
Publishing country	United States
Document type	Journal Article
ISSN	2689-288X
ISSN (online)	2689-288X
DOI	10.1089/neur.2023.0108
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Article ; Online: Prognostic value of near-infrared spectroscopy regional oxygen saturation and cerebrovascular reactivity index in acute traumatic neural injury: a CAnadian High-Resolution Traumatic Brain Injury (CAHR-TBI) Cohort Study.

Gomez, Alwyn / Froese, Logan / Griesdale, Donald / Thelin, Eric P / Raj, Rahul / van Iperenburg, Levi / Tas, Jeanette / Aries, Marcel / Stein, Kevin Y / Gallagher, Clare / Bernard, Francis / Kramer, Andreas H / Zeiler, Frederick A

Critical care (London, England)

2024 Volume 28, Issue 1, Page(s) 78

Abstract: Background: Near-infrared spectroscopy regional cerebral oxygen saturation (rSO: Methods: A retrospective multi-institutional cohort study was performed. The cohort included TBI patients treated in four adult intensive care units (ICU). The cerebral ... ...

Abstract	Background: Near-infrared spectroscopy regional cerebral oxygen saturation (rSO Methods: A retrospective multi-institutional cohort study was performed. The cohort included TBI patients treated in four adult intensive care units (ICU). The cerebral oxygen indices, COx (using rSO Results: In the cohort of 129 patients, there was no identifiable threshold for raw rSO Conclusions: In this multi-institutional cohort study, raw rSO
MeSH term(s)	Adult ; Humans ; Cohort Studies ; Prognosis ; Retrospective Studies ; Spectroscopy, Near-Infrared/methods ; Oxygen Saturation ; Canada ; Brain Injuries, Traumatic/diagnostic imaging
Language	English
Publishing date	2024-03-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-024-04859-6
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Article ; Online: Individualizing Cerebral Perfusion Pressure Targets.

Bernard, Francis / Albert, Martin / Brunette, Véronique

Critical care medicine

2018 Volume 46, Issue 2, Page(s) e175

MeSH term(s)	Cerebrovascular Circulation ; Homeostasis ; Intracranial Pressure ; Perfusion
Language	English
Publishing date	2018-02-14
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0000000000002792
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