In this episode of Hot Topics, Dr. Nicholas Morris interviews Dr. Giuseppe Citerio, professor of anesthesia and intensive care at Milano-Bicocca University, about the ORANGE study, which investigated the neurological pupil index (NPI) for prognosticating outcomes in patients with acute brain injury. The study, involving 13 centers in Europe and North America, found that repeat abnormal NPI values, including zero, were predictors of poor outcomes. The study collected data every four hours for seven days and used a sophisticated statistical model to account for longitudinal changes. Despite initial expectations, the study did not find a strong correlation between the NPI and ICP, suggesting NPI should not be used as a surrogate for ICP. Future research may focus on developing a standardized response to low NPI values. Show Notes: <a href= "https://doi.org/10.1016/S1474-4422(23)00271-5">https://doi.org/10.1016/S1474-4422(23)00271-5</a> Oddo M, Taccone FS, Petrosino M, Badenes R, Blandino-Ortiz A, Bouzat P, Caricato A, Chesnut RM, Feyling AC, Ben-Hamouda N, Hemphill JC. The Neurological Pupil index for outcome prognostication in people with acute brain injury (ORANGE): a prospective, observational, multicentre cohort study. The Lancet Neurology. 2023 Oct 1;22(10):925-33.

<description>&lt;p class="MsoNormal"&gt;In this episode of &lt;em&gt;Hot Topics&lt;/em&gt;, Dr. Nicholas Morris interviews Dr. Giuseppe Citerio, professor of anesthesia and intensive care at Milano-Bicocca University, about the ORANGE study, which investigated the neurological pupil index (NPI) for prognosticating outcomes in patients with acute brain injury. The study, involving 13 centers in Europe and North America, found that repeat abnormal NPI values, including zero, were predictors of poor outcomes. The study collected data every four hours for seven days and used a sophisticated statistical model to account for longitudinal changes. Despite initial expectations, the study did not find a strong correlation between the NPI and ICP, suggesting NPI should not be used as a surrogate for ICP. Future research may focus on developing a standardized response to low NPI values.&lt;/p&gt; &lt;p class="MsoNormal"&gt;Show Notes:&lt;/p&gt; &lt;p class="MsoNormal" style="margin-left: .5in;"&gt;&lt;a href= "https://doi.org/10.1016/S1474-4422(23)00271-5"&gt;https://doi.org/10.1016/S1474-4422(23)00271-5&lt;/a&gt;&lt;/p&gt; &lt;p class="MsoNormal" style="margin-left: .5in;"&gt;Oddo M, Taccone FS, Petrosino M, Badenes R, Blandino-Ortiz A, Bouzat P, Caricato A, Chesnut RM, Feyling AC, Ben-Hamouda N, Hemphill JC. The Neurological Pupil index for outcome prognostication in people with acute brain injury (ORANGE): a prospective, observational, multicentre cohort study. The Lancet Neurology. 2023 Oct 1;22(10):925-33.&lt;/p&gt;</description>

In this episode of Hot Topics, Dr. Nicholas Morris interviews Dr. Giuseppe Citerio, professor of anesthesia and intensive care at Milano-Bicocca University, about the ORANGE study, which investigated the neurological pupil index (NPI) for...

HOT TOPICS: The ORANGE Study With Dr. Giuseppe Citerio

On September 2022, Cameron Kuklick fell from a motorized rental scooter while returning to his hotel after celebrating his brother’s wedding in Harrisonburg, Virginia. Cameron experienced a severe traumatic brain injury (TBI) at the age of 30. Cameron and his family hope that by sharing their story and experiences, they too can provide hope and healing for others. In this week’s episode, Cameron joins Dr. Lauren Koffman and Dea Mahanes, DNP, APRN, CCNS, HEC-C, FNCS, who was on Cameron's care team, to discuss his Story of Hope. You can read Cameron's story in Currents at <a href= "https://currents.neurocriticalcare.org/Stories-of-Hope/Article/unbroken-stride-camerons-story-of-hope-overcoming-brain-injury-to-cross-the-finish-line" target="_blank" rel= "noopener">https://currents.neurocriticalcare.org/Stories-of-Hope/Article/unbroken-stride-camerons-story-of-hope-overcoming-brain-injury-to-cross-the-finish-line</a>.

<description>&lt;p class="MsoNormal"&gt;On September 2022, Cameron Kuklick fell from a motorized rental scooter while returning to his hotel after celebrating his brother’s wedding in Harrisonburg, Virginia. Cameron experienced a severe traumatic brain injury (TBI) at the age of 30. Cameron and his family hope that by sharing their story and experiences, they too can provide hope and healing for others. &lt;span lang="EN-US" xml:lang="EN-US"&gt;In this week’s episode, Cameron joins Dr. Lauren Koffman and Dea Mahanes, DNP, APRN, CCNS, HEC-C, FNCS, who was on Cameron's care team, to discuss his Story of Hope.&lt;/span&gt;&lt;/p&gt; &lt;p class="MsoNormal"&gt;&lt;span lang="EN-US" xml:lang="EN-US"&gt;You can read Cameron's story in &lt;em&gt;Currents&lt;/em&gt; at &lt;a href= "https://currents.neurocriticalcare.org/Stories-of-Hope/Article/unbroken-stride-camerons-story-of-hope-overcoming-brain-injury-to-cross-the-finish-line" target="_blank" rel= "noopener"&gt;https://currents.neurocriticalcare.org/Stories-of-Hope/Article/unbroken-stride-camerons-story-of-hope-overcoming-brain-injury-to-cross-the-finish-line&lt;/a&gt;.&lt;/span&gt;&lt;/p&gt;</description>

Overcoming Brain Injury to Cross the Finish Line

CURRENTS: Unbroken Stride: Cameron’s Story of Hope

In this week's episode of Perspectives, Dr Nicholas Morris is joined by NCS Past President, Dr Gretchen Brophy, Professor of Pharmacotherapy & Outcomes Sciences and Neurosurgery with Virginia Commonwealth University (VCU) School of Pharmacy, Medical College of Virginia Campus, in Richmond.

<description>&lt;p&gt;In this week's episode of &lt;em&gt;Perspectives&lt;/em&gt;, Dr Nicholas Morris is joined by NCS Past President, Dr Gretchen Brophy, Professor of Pharmacotherapy &amp; Outcomes Sciences and Neurosurgery with Virginia Commonwealth University (VCU) School of Pharmacy, Medical College of Virginia Campus, in Richmond.&lt;/p&gt;</description>

In this week's episode of Perspectives, Dr Nicholas Morris is joined by NCS Past President, Dr Gretchen Brophy, Professor of Pharmacotherapy & Outcomes Sciences and Neurosurgery with Virginia Commonwealth University (VCU) School of Pharmacy,...

PERSPECTIVES: Dr Gretchen Brophy

Electroencephalography (EEG) is an important and relatively inexpensive tool that allows intensivists to monitor cerebral activity of critically ill patients in real time. Seizure detection in patients with and without acute brain injury is the primary reason to obtain an EEG in the Intensive Care Unit (ICU); and in response to the increased demand for EEG, advances in quantitative EEG (qEEG) created an approach to review large amounts of data instantly. Today, rapid response EEG is now available to reduce the time to detect electrographic seizures in limited-resource settings. In this week's MasterClass, our hosts Dr Jon Rosenberg and Dr Stephan Mayer are joined by Dr Lawerence Hirsch, Co-Director of the Critical Care EEG Monitoring Program at Yale School of Medicine to discuss the evolution, value, and impact of brain monitoring with EEG in the critically ill.

<description>&lt;p&gt;Electroencephalography (EEG) is an important and relatively inexpensive tool that allows intensivists to monitor cerebral activity of critically ill patients in real time. Seizure detection in patients with and without acute brain injury is the primary reason to obtain an EEG in the Intensive Care Unit (ICU); and in response to the increased demand for EEG, advances in quantitative EEG (qEEG) created an approach to review large amounts of data instantly. Today, rapid response EEG is now available to reduce the time to detect electrographic seizures in limited-resource settings. In this week's MasterClass, our hosts Dr Jon Rosenberg and Dr Stephan Mayer are joined by Dr Lawerence Hirsch, Co-Director of the Critical Care EEG Monitoring Program at Yale School of Medicine to discuss the evolution, value, and impact of brain monitoring with EEG in the critically ill. &lt;/p&gt;</description>

Electroencephalography (EEG) is an important and relatively inexpensive tool that allows intensivists to monitor cerebral activity of critically ill patients in real time. Seizure detection in patients with and without acute brain injury is the...

MASTERCLASS: Critical Care EEG Monitoring

The purpose of informed consent, as it exists now, is primarily to maintain patient autonomy, but additional benefits include the protection of patients, avoidance of fraud, and promotion of rational decisions, amongst others. It is now considered both an ethical and legal obligation which should, at a minimum, always include: 1) the nature of the procedure, 2) the risks and benefits of the procedure, 3) reasonable alternatives, and 4) risks and benefits of alternatives, with an assessment of comprehension of these elements (1). This week Dr Lauren Koffman is joined by Clotilde Balucani, MD and Julia Durrant, MD two of the authors of the recent <a href= "https://currents.neurocriticalcare.org/Leading-Insights/Article/consent-for-brain-death-determination-the-ends-justify-the-means-or-it-does-not" target="_blank" rel="noopener">Currents article</a> Consent for Brain Death Determination - the ends justify the means... or it does not.

<description>&lt;p&gt;The purpose of informed consent, as it exists now, is primarily to maintain patient autonomy, but additional benefits include the protection of patients, avoidance of fraud, and promotion of rational decisions, amongst others. It is now considered both an ethical and legal obligation which should, at a minimum, always include: 1) the nature of the procedure, 2) the risks and benefits of the procedure, 3) reasonable alternatives, and 4) risks and benefits of alternatives, with an assessment of comprehension of these elements (1). This week Dr Lauren Koffman is joined by Clotilde Balucani, MD and Julia Durrant, MD two of the authors of the recent &lt;a href= "https://currents.neurocriticalcare.org/Leading-Insights/Article/consent-for-brain-death-determination-the-ends-justify-the-means-or-it-does-not" target="_blank" rel="noopener"&gt;&lt;em&gt;Currents&lt;/em&gt; article&lt;/a&gt; &lt;em&gt;Consent for Brain Death Determination - the ends justify the means... or it does not.&lt;/em&gt;&lt;/p&gt;</description>

The purpose of informed consent, as it exists now, is primarily to maintain patient autonomy, but additional benefits include the protection of patients, avoidance of fraud, and promotion of rational decisions, amongst others. It is now considered...

CURRENTS: Consent for Brain Death Determination - the ends justify the means... or it does not.

The goal of the Neurocritical Care Society Podcast is to summarize some of the latest content and cutting edge research published in the journal, Neurocritical Care, official journal of the Neurocritical Care Society. Episodes are produced regularly and feature interviews with the top researchers around the world in the fields of neurology, critical care, and neurosurgery.

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