Neurosurgery – decision to operate

In patients with a variety of acute neurosurgical ‘injuries’ the absence of pupillary responses, and failure of mannitol (or similar agent) to alter this, is often used as evidence for futility and subsequent refusal of surgical intervention (+/- transfer, if from a DGH). Is this a reasonable? A – A neurological “injury” worth mentioning, although not a neurosurgical one, is … More Neurosurgery – decision to operate

April / May 2017 Journal Club

A bit of a 2 for 1 job this month as we discussed two papers touching on similar themes; namely what’s the best “non-invasive” option to manage acute onset, non-cardiac, respiratory failure? Paper 1 (http://www.nejm.org/doi/full/10.1056/NEJMoa1503326#t=article) Paper 2 (http://journals.lww.com/ccmjournal/Abstract/2016/02000/Failure_of_Noninvasive_Ventilation_for_De_Novo.6.aspx) Have a read of the comments below and feel free to add your own! Re paper 1 “Hi … More April / May 2017 Journal Club