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By Neurocritical Care Society
5
4343 ratings
The podcast currently has 211 episodes available.
The most played episodes among Podcast App listeners.

In this episode of the NCS Podcast Hot Topics series, host Rich Choi, DO, is joined by Andrew Webb, PharmD, to discuss the article "Valproic Acid for the Management of Agitation in Neurosurgical Intensive Care Unit Patients," published in Neurocritical Care. Their conversation examines the complex causes of delirium and agitation in the neurocritical care setting, including neurologic injury, medication effects, sleep disruption and frequent clinical interventions. They review nonpharmacologic approaches to delirium prevention, current sedation strategies and the potential role of valproic acid as an adjunct when agitation remains difficult to control. They also discuss findings from the retrospective study, in which valproic acid use was associated with reduced requirements for opioids, benzodiazepines and dexmedetomidine, along with fewer positive agitation scores and less use of physical restraints. Dr. Webb reviews the medication's multimodal effects, potential adverse events and drug interactions, and patient populations that may benefit from its use. He also emphasizes the need for careful monitoring, eventual deprescribing and prospective research to clarify valproic acid's role in neurocritical care. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this bonus episode of the NCS Podcast Hot Topics series, host Rich Choi, MD, continues his conversation with Andrew Webb, PharmD, with a preview of "Subarachnoid Hemorrhage: Clazosentan vs. Fasudil for Vasospasm Prevention (SAVIOR) Study: Study Protocol for a Prospective, Multicenter, Randomized Trial," published in Neurocritical Care. They review the history of nimodipine as the standard treatment for improving outcomes after aneurysmal subarachnoid hemorrhage and compare its mechanism with those of fasudil and clazosentan. Dr. Webb explains why fasudil is commonly used for vasospasm prevention in Japan and discusses previous research showing that clazosentan can reduce vasospasm without consistently improving functional outcomes when added to nimodipine. The conversation also explores how the SAVIOR trial will directly compare clazosentan and fasudil in a nimodipine-free population. They consider whether the trial could establish a preferred approach in Japan, what its results might mean for practice elsewhere and whether clazosentan may eventually have a role for selected patients who cannot tolerate nimodipine. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Rich Choi, DO, welcomes back Andrew Webb, PharmD, to unpack "Effect of Desmopressin on Attaining Therapeutic Hypernatremia with Hypertonic Saline Continuous Infusion in Intracranial Hemorrhage," recently published in Neurocritical Care. Desmopressin has become a familiar tool for blunting antiplatelet-associated bleeding in intracranial hemorrhage, but its vasopressin-receptor activity raises a concern. Does it work against efforts to raise sodium with hypertonic saline? Dr. Webb traces desmopressin's path from a 1970s antidiuretic drug for diabetes insipidus to a hemostatic agent borrowed from the hemophilia literature, then walks through its pharmacokinetics, typical hemostatic dosing and the relatively modest side-effect profile clinicians should watch for. The conversation turns to a single-center retrospective study that paired a protocolized, TEG-guided desmopressin dose with a nurse-driven hypertonic saline sliding-scale infusion targeting a sodium goal of 150–155 mEq/L. Drs. Choi and Webb walk through how the study was designed and what it found, touching on sodium goal attainment, TEG changes, 3% saline volumes and thromboembolic risk. They also dig into the study's limitations, including its more conservative desmopressin dosing relative to practice at other centers, and agree a randomized trial is still needed to settle desmopressin's role in ICH management more broadly. For clinicians giving desmopressin alongside hypertonic saline, Dr. Webb offers a practical piece of advice worth tuning in for. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Currents series, host Lauren Koffman, DO, MS, FCCM, speaks with Tarek El Halabi, MD, who leads acute neurology services at the American University of Beirut Medical Center, about his Currents article, "Neurocritical Care in Lebanon: Progress Within Constraint." El Halabi didn't build a neuro ICU from the ground up. He joined an already established mixed medical-surgical unit and worked to change it from within, winning over colleagues and standardizing care for the emergencies that arise most often, including stroke, status epilepticus and bleeds. He and Koffman talk through what that took, from identifying the right people to lead each effort to investing heavily in nursing and resident training. While technical skills can be learned relatively quickly, building a lasting culture takes much longer. They also dig into what "resource-limited" really means in a country with highly trained physicians and advanced medicine. In Lebanon, El Halabi explains, the constraint isn't expertise, but financial access and consistency, since a patient's care can depend heavily on their insurance and where they happen to present. He describes how his team redesigned stroke workflows to meet AHA/ASA benchmarks despite these limits, as well as where the program goes from here, including adding more faculty, developing a neuro ICU fellowship, strengthening research ties with NCS's MENA region colleagues, and eventually expanding telemedicine outreach beyond Beirut. To read the full article, visit NCS Currents. The views expressed on the NCS Podcast are solely those of the hosts and guests and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.

In this episode of the NCS Podcast Hot Topics series, host Eric Lawson, MD, speaks with NCS Vice President and Annual Meeting Planning Committee Chair Lori Shutter, MD, FNCS, for a preview of the NCS 24th Annual Meeting, taking place Oct. 20-23 in Seattle. Dr. Shutter discusses this year's theme, "Reaching New Heights: Advancing the Future of Neurocritical Care," and how it reflects the Society's continued growth and optimism about the future of the field. The conversation offers a look at expanded workshop offerings, including sessions on the essentials of neurocritical care, critical care procedures, point-of-care and neurofocused ultrasound, and informatics and big data. Dr. Shutter also previews keynote addresses from Walter Koroshetz, MD, and Lisa Meeks, PhD, along with sessions focused on clinical trials, physiology, pediatric neurocritical care, global health, professional development and sustainability in the ICU. Listeners will also learn about opportunities for first-time attendees and new members, the return of the leadership closing panel and an open brainstorming session focused on the Society's next major area of research. Dr. Shutter shares how attendee feedback shaped this year's program and offers advice for making the most of the meeting's concurrent sessions, networking opportunities and special events. The views expressed on the NCS Podcast are solely those of the host and guest and do not necessarily reflect the opinions or official positions of the Neurocritical Care Society.
The podcast currently has 211 episodes available.

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