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  1. Article ; Online: Intracranial pressure pulse morphology: the missing link?

    Brasil, Sérgio

    Intensive care medicine

    2022  Volume 48, Issue 11, Page(s) 1667–1669

    MeSH term(s) Humans ; Intracranial Pressure ; Blood Pressure ; Heart Rate
    Language English
    Publishing date 2022-08-29
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-022-06855-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1089: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Brain Death Diagnostic Security is Over Organ Donation.

    Brasil, Sérgio

    Transplantation proceedings

    2021  Volume 53, Issue 7, Page(s) 2415

    MeSH term(s) Brain Death/diagnosis ; Humans ; Organ Transplantation ; Tissue Donors ; Tissue and Organ Procurement
    Language English
    Publishing date 2021-08-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 82046-5
    ISSN 1873-2623 ; 0041-1345
    ISSN (online) 1873-2623
    ISSN 0041-1345
    DOI 10.1016/j.transproceed.2021.07.048
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    Zs.A 835: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Mistaken concepts on the use of ancillary testing in brain death diagnosis.

    Brasil, Sérgio

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2021  Volume 69, Issue 3, Page(s) 405–406

    MeSH term(s) Brain ; Brain Death/diagnosis ; Humans ; Ultrasonography, Doppler, Transcranial
    Language English
    Publishing date 2021-12-22
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-021-02185-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 109: Show issues Location:
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  4. Article ; Online: A new noninvasive method can effectively assess intracranial compliance. Letter to the Editor.

    Brasil, Sérgio / Godoy, Daniel Agustín

    Acta neurochirurgica

    2023  Volume 165, Issue 8, Page(s) 2213–2214

    MeSH term(s) Humans ; Intracranial Pressure
    Language English
    Publishing date 2023-05-22
    Publishing country Austria
    Document type Letter
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-023-05644-0
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    Uk I Zs.180: Show issues Location:
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  5. Article ; Online: Noninvasive neuromonitoring in acute brain injured patients.

    Brasil, Sérgio / Chesnut, Randall / Robba, Chiara

    Intensive care medicine

    2024  

    Language English
    Publishing date 2024-04-17
    Publishing country United States
    Document type Editorial
    ZDB-ID 80387-x
    ISSN 1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
    ISSN (online) 1432-1238
    ISSN 0340-0964 ; 0342-4642 ; 0935-1701
    DOI 10.1007/s00134-024-07406-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1089: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: A Narrative Review on Financial Challenges and Health Care Costs Associated with Traumatic Brain Injury in the United States.

    Valentim, Wander / Bertani, Raphael / Brasil, Sergio

    World neurosurgery

    2024  Volume 187, Page(s) 82–92

    Abstract: Background: Traumatic brain injury (TBI) is a highly prevalent and potentially severe medical condition. Challenges regarding TBI management are related to accurate diagnostics, defining its severity, and establishing prompt interventions to affect ... ...

    Abstract Background: Traumatic brain injury (TBI) is a highly prevalent and potentially severe medical condition. Challenges regarding TBI management are related to accurate diagnostics, defining its severity, and establishing prompt interventions to affect outcomes. Among the health care components in the TBI handling strategy is intracranial pressure (ICP) monitoring, which is fundamental to therapy decisions. However, ICP monitoring is an Achilles tendon, imposing a significant financial burden on health care systems, particularly in middle and low-income communities. This article arises from the understanding from the authors that there is insufficient scientific evidence about the potential economic impacts from the use of noninvasive technologies in the monitoring of TBI. Based on personal experience, as well as from reading other, clinically focused studies, the thesis is that the use of such technologies could greatly affect the health care system and this article seeks to address this lack of literature, show ways in which such systems could be evaluated, and show estimations of possible results from these investigations.
    Objective: This review primarily investigates the economic burden of TBI and whether new technologies are suitable to reduce its health care costs without compromising the quality of care, according to the levels of evidence available. The objective is to stimulate more research and attention in the area.
    Methods: For this narrative review, a PubMed search was conducted for articles discussing TBI health care costs, as well as monitoring technologies (tomography, magnetic resonance imaging, optic nerve sheath diameter, transcranial Doppler, pupillometry, and noninvasive ICP waveform) and their application in managing TBI. Strategies were first evaluated from a medical noninferiority perspective before calculating the average savings of each selected strategy. All applicable studies were analyzed for quality using the Consolidated Health Economic Evaluation Reporting Standards 2022 Statement
    Results: The review included 109 references and showed a consistent potential in noninvasive technologies to reduce costs and maintain or improve the quality of care.
    Conclusions: TBI prevalence has increased with a disproportionate health care burden in the last decades. Noninvasive monitoring techniques seem to be effective in reducing TBI health care costs, with few limitations, especially the need for more supporting scientific evidence. The undeniable clinical and financial potential of these techniques is compelling to further investigate their role in TBI management, as well as the creation of more comprehensive monitoring models to the understanding of complex phenomena occurring in the injured brain.
    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2024.03.175
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    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Neuromonitoring-Here, There, and to Every Critically Ill Patient.

    Caldas, Juliana / Brasil, Sergio / Passos, Rogério

    Critical care medicine

    2023  Volume 51, Issue 9, Page(s) e189–e191

    MeSH term(s) Humans ; Critical Illness/therapy
    Language English
    Publishing date 2023-08-17
    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.0000000000005926
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Doing More with Less on Intracranial Pressure Monitoring.

    Brasil, Sérgio / Godoy, Daniel A / Paiva, Wellingson S

    World neurosurgery

    2023  Volume 178, Page(s) 93–95

    Abstract: Background: Intracranial pressure (ICP) management based on predetermined thresholds is not accurate in light of recent research on cerebrovascular physiology. Interpersonal and intrapersonal variations will lead ICP elevations to reach individualized ... ...

    Abstract Background: Intracranial pressure (ICP) management based on predetermined thresholds is not accurate in light of recent research on cerebrovascular physiology. Interpersonal and intrapersonal variations will lead ICP elevations to reach individualized thresholds for intracranial compliance impairment from one subject to another. Therefore reuniting the modern techniques of neuromonitoring besides ICP enables practitioners to have a more whole picture in anticipating neuro worsening and improving timing in decision making.
    Methods: Brief literature review.
    Results: For the severely brain-injured patient, current evidence indicates a personalized and physiology-based multimodal monitoring care to be required rather than decision making according to ICP predetermined cut-offs.
    Conclusions: The authors' point of view is of particular importance for regions with resource heterogeneity and scarcity, where ICP monitoring is not available for all those in need and noninvasive techniques may provide a surrogate approach. If physicians who deal with acute-brain-injured patients in lower-resource areas understand that several tools besides ICP may improve their practice, it is possible to reduce acute brain injury morbimortality.
    MeSH term(s) Humans ; Brain ; Brain Injuries ; Cerebrovascular Circulation ; Intracranial Hypertension/diagnosis ; Intracranial Pressure/physiology ; Monitoring, Physiologic/methods
    Language English
    Publishing date 2023-07-22
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.07.055
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  9. Article ; Online: A Point-of-Care Noninvasive Technique for Surrogate ICP Waveforms Application in Neurocritical Care.

    Brasil, Sérgio / Godoy, Daniel A / Hawryluk, Gregory W J

    Neurocritical care

    2023  Volume 40, Issue 1, Page(s) 170–176

    MeSH term(s) Humans ; Intracranial Pressure ; Point-of-Care Systems ; Intracranial Hypertension ; Critical Care/methods
    Language English
    Publishing date 2023-07-12
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2381896-7
    ISSN 1556-0961 ; 1541-6933
    ISSN (online) 1556-0961
    ISSN 1541-6933
    DOI 10.1007/s12028-023-01786-2
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    Zs.A 6538: Show issues Location:
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  10. Article ; Online: ICP wave morphology as a screening test to exclude intracranial hypertension in brain-injured patients: a non-invasive perspective.

    de Moraes, Fabiano Moulin / Brasil, Sérgio / Frigieri, Gustavo / Robba, Chiara / Paiva, Wellingson / Silva, Gisele Sampaio

    Journal of clinical monitoring and computing

    2024  

    Abstract: Intracranial hypertension (IH) is a life-threating condition especially for the brain injured patient. In such cases, an external ventricular drain (EVD) or an intraparenchymal bolt are the conventional gold standard for intracranial pressure (ICPi) ... ...

    Abstract Intracranial hypertension (IH) is a life-threating condition especially for the brain injured patient. In such cases, an external ventricular drain (EVD) or an intraparenchymal bolt are the conventional gold standard for intracranial pressure (ICPi) monitoring. However, these techniques have several limitations. Therefore, identifying an ideal screening method for IH is important to avoid the unnecessary placement of ICPi and expedite its introduction in patients who require it. A potential screening tool is the ICP wave morphology (ICPW) which changes according to the intracranial volume-pressure curve. Specifically, the P2/P1 ratio of the ICPW has shown promise as a triage test to indicate normal ICP. In this study, we propose evaluating the noninvasive ICPW (nICPW-B4C sensor) as a screening method for ICPi monitoring in patients with moderate to high probability of IH. This is a retrospective analysis of a prospective, multicenter study that recruited adult patients requiring ICPi monitoring from both Federal University of São Paulo and University of São Paulo Medical School Hospitals. ICPi values and the nICPW parameters were obtained from both the invasive and the noninvasive methods simultaneously 5 min after the closure of the EVD drainage. ICP assessment was performed using a catheter inserted into the ventricle and connected to a pressure transducer and a drainage system. The B4C sensor was positioned on the patient's scalp without the need for trichotomy, surgical incision or trepanation, and the morphology of the ICP waves acquired through a strain sensor that can detect and monitor skull bone deformations caused by changes in ICP. All patients were monitored using this noninvasive system for at least 10 min per session. The area under the curve (AUC) was used to describe discriminatory power of the P2/P1 ratio for IH, with emphasis in the Negative Predictive value (NPV), based on the Youden index, and the negative likelihood ratio [LR-]. Recruitment occurred from August 2017 to March 2020. A total of 69 patients fulfilled inclusion and exclusion criteria in the two centers and a total of 111 monitorizations were performed. The mean P2/P1 ratio value in the sample was 1.12. The mean P2/P1 value in the no IH population was 1.01 meanwhile in the IH population was 1.32 (p < 0.01). The best Youden index for the mean P2/P1 ratio was with a cut-off value of 1.13 showing a sensitivity of 93%, specificity of 60%, and a NPV of 97%, as well as an AUC of 0.83 to predict IH. With the 1.13 cut-off value for P2/P1 ratio, the LR- for IH was 0.11, corresponding to a strong performance in ruling out the condition (IH), with an approximate 45% reduction in condition probability after a negative test (ICPW). To conclude, the P2/P1 ratio of the noninvasive ICP waveform showed in this study a high Negative Predictive Value and Likelihood Ratio in different acute neurological conditions to rule out IH. As a result, this parameter may be beneficial in situations where invasive methods are not feasible or unavailable and to screen high-risk patients for potential invasive ICP monitoring.Trial registration: At clinicaltrials.gov under numbers NCT05121155 (Registered 16 November 2021-retrospectively registered) and NCT03144219 (Registered 30 September 2022-retrospectively registered).
    Language English
    Publishing date 2024-02-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1418733-4
    ISSN 1573-2614 ; 1387-1307 ; 0748-1977
    ISSN (online) 1573-2614
    ISSN 1387-1307 ; 0748-1977
    DOI 10.1007/s10877-023-01120-3
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    Zs.A 2054: Show issues Location:
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