NCS is a multidisciplinary, international organization whose mission is to improve outcomes for patients with critical neurological illnesses.
Chicago, IL
Joined March 2011
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Neurocritical Care Society retweeted
I voted for functional but your thought process makes me hold DCI in higher regard for outcomes.
Important we don't just think of patients as numbers (ie mRS) and take into consideration what they hold as a 'good' outcome. #NCSTJC
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Neurocritical Care Society retweeted
I voted DCI incidence as I believe is the most meaningful outcome tied to vasospasm prevention and treatment. Functional outcome is the ultimate goal but will be affected by multiple factors not necessarily related to vasospasm. #NCSTJC
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SBP goals make sense for rebleed/bleed expansion as that's better correlated with shear force against a vessel wall, but for vasospasm treatment it probably doesn't make a big difference
I want to see who's out there using DBP targets... there's gotta be someone #NCSTJC
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This is my major criticism of this study as well - would have been interesting to look at their aSAH outcomes over time irrespective of milrinone. They may have just gotten better at aSAH, had more sensitive imaging to detect spasm, etc #NCSTJC
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I voted functional outcomes, but with the complexity of aSAH care its hard to isolate the effect size of 1️⃣ intervention
VS resolution is great but is still a surrogate outcome. Whether it's the spasm or something like CSD driving outcomes has yet to be seen #NCSTJC
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Q5: What is the most meaningful outcome to assess in vasospasm treatment studies for SAH? #NCSTJC @theABofPharmaC @karenccrx
1%
Angiographic ↓ vasospasm
30%
Incidence of DCI
68%
Functional outcome
0%
Other (reply)
82 votes • Final results
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Neurocritical Care Society retweeted
Especially in absence concurrent heart failure, high output state induced by milrinone presumably causes kidney hyperperfusion, diuresis and natriuresis, with K loss.
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Neurocritical Care Society retweeted
#NCSTJC
Some other studies have proposed much higher dose intervals for Milrinone, as for example 2-3 mcg/kg/min. Quite high dose when compared to general indications for Milninone like right vetricular failure? Does anyone has comments on that?
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Neurocritical Care Society retweeted
CVP > 6. An old hemodynamic test. Do you perform other? #NCSTJC
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Neurocritical Care Society retweeted
We dont use for VE. By now is off label. May be this discussion help to use. #NCSTJC
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Neurocritical Care Society retweeted
It's a great option for those who can tolerate it without experiencing the potential adverse effects. Hypotension and arrhythmias can limit its utility-- especially in a setting where you may be simultaneously augmenting/maintaining BP with pressors. #NCSTJC
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