Neurocritical Care最新文献

{"title":"Description of STRIVE-ON Study Protocol: Safety and Tolerability of GTX-104 (Nimodipine Injection for IV Infusion) Compared with Oral Nimodipine in Patients Hospitalized for Aneurysmal Subarachnoid Hemorrhage (aSAH): A Prospective, Randomized, Phase III Trial (STRIVE-ON).","authors":"Alex H Choi, Sherry Y Chou, Andrew F Ducruet, W Taylor Kimberly, R Loch Macdonald, Alejandro A Rabinstein","doi":"10.1007/s12028-024-02207-8","DOIUrl":"https://doi.org/10.1007/s12028-024-02207-8","url":null,"abstract":"<p><p>Oral nimodipine is the only drug approved in North America for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, bioavailability is variable and frequently poor, leading to fluctuations in peak plasma concentrations that cause dose-limiting hypotension. Furthermore, administration is problematic in patients who cannot swallow. An oral liquid formulation exists but causes diarrhea. An intravenous nimodipine formulation (GTX-104) has been developed that has bioavailability approaching 100% and is not affected by feeding or gastrointestinal absorption. GTX-104 causes less hypotension and has more consistent peak plasma concentrations than oral nimodipine in human volunteers. Herein, we describe the protocol of a prospective, randomized, open-label safety, and tolerability study of GTX-104 compared with oral nimodipine in patients with aSAH (Safety and Tolerability of GTX-104 [Nimodipine Injection for Intravenous Infusion] Compared with Oral Nimodipine; ClinicalTrials.gov identifier: NCT05995405). The study is designed to seek approval of GTX-104 by the Food and Drug Administration 505(b)(2) pathway. Inclusion and exclusion criteria match the prescribing information for oral nimodipine and include adult patients with aSAH of all Hunt and Hess grades who can receive investigational product within 96 h of aSAH. Study participants at imminent risk of death will be excluded. Study participants will be randomly assigned 1:1 to receive GTX-104 or oral nimodipine for up to 21 days. The primary end point is the proportion of study participants with clinically significant hypotension, defined as hypotension requiring treatment that has a reasonable likelihood of being due to investigational product as determined by an independent, blinded end point adjudication committee. No statistical analysis of the end point is planned. Secondary end points include all episodes of hypotension, all adverse events, delayed cerebral ischemia, rescue therapy, and suicidal ideation. Clinical and health economic outcomes include quality of life using the EuroQol 5-dimension/3-level, modified Rankin Scale score at 30 and 90 days after aSAH and hospital resource use. The planned sample size is 100 study participants across 25 sites in the United States and Canada.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-Cost Strategies for the Development of Neurocritical Care in Resource-Limited Settings.","authors":"Gentle Sunder Shrestha, Gaurav Nepal, Sérgio Brasil","doi":"10.1007/s12028-025-02215-2","DOIUrl":"https://doi.org/10.1007/s12028-025-02215-2","url":null,"abstract":"<p><p>This review explores low-cost neurocritical care interventions for resource-limited settings, including economical devices, innovative care models, and disease-specific strategies. Devices like inexpensive ventilators, wearable technology, smartphone-based ultrasound, brain4care, transcranial Doppler, and smartphone pupillometry offer effective diagnostic and monitoring capabilities. Initiatives such as intermediate care units, minimally equipped stroke units, and tele-neurocritical care have demonstrated benefits by reducing hospital stays, preventing complications, and improving clinical and economic outcomes. The review emphasizes locally applicable tailored approaches for diagnosing and managing conditions such as traumatic brain injury, neuroinfections, status epilepticus, autoimmune neurological disorders, and acute stroke as viable and affordable solutions.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketamine Versus Midazolam as the First-Line Continuous Infusion for Status Epilepticus in Children with Cardiac Disease.","authors":"David E Horvat, Julia S Keenan, Sam Javadian, Yu-Ting Liu, Shruthi Voleti, Katelyn Staso, Caroline Conley, Sarah D Schlatterer, Arnold J Sansevere, Dana B Harrar","doi":"10.1007/s12028-025-02212-5","DOIUrl":"https://doi.org/10.1007/s12028-025-02212-5","url":null,"abstract":"<p><strong>Background: </strong>The treatment of status epilepticus (SE) in children with cardiac disease is challenging given their often-tenuous hemodynamic state. We aim to determine whether ketamine is safe and effective in children with cardiac disease as the first-line continuous infusion for the treatment of refractory SE (RSE) and to compare ketamine to midazolam for the treatment of RSE in this population.</p><p><strong>Methods: </strong>This is a single-center retrospective cohort study of pediatric patients with cardiac disease and RSE admitted to the cardiac intensive care unit at a tertiary children's hospital between January 1, 2017 and June 30, 2023. Consecutive patients < 18 years of age who had electroencephalogram-confirmed RSE treated with a continuous infusion of ketamine and/or midazolam were included. Clinical variables were extracted from the electronic medical record, and descriptive statistics were used.</p><p><strong>Results: </strong>Thirty-four patients with cardiac disease and RSE were treated with a continuous infusion: 15 were treated with ketamine first, and 19 were treated with midazolam first. An equivalent number of patients in both groups required a single infusion for seizure cessation (11 [73%] in the ketamine group and 12 [63%] in the midazolam group; p = 0.72). The median time from seizure onset to seizure cessation, time from seizure onset to initiation of a continuous infusion, time from initiation of a continuous infusion to seizure cessation, infusion duration, and recurrence of seizures during weaning of the continuous infusion were comparable between groups. There was no difference between groups in the proportion of patients who experienced potential adverse events attributable to their continuous infusion.</p><p><strong>Conclusions: </strong>This retrospective cohort study provides evidence that ketamine may be as effective as midazolam as the first-line continuous infusion for RSE in children with cardiac disease. This study also provides preliminary evidence of safety in this population, at least in comparison to midazolam.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predisposing Factors of Progression from Refractory Status Epilepticus to Super-Refractory Status Epilepticus in ICU-Admitted Patients: Multicenter Retrospective Cohort Study in a Resource-Limited Setting.","authors":"Dannys Rivero Rodríguez, Telmo Fernandez, Daniela DiCapua Sacoto, Yanelis Pernas Sanchez, María Isabel Morales-Casado, Nelson Maldonado, Graham Pluck","doi":"10.1007/s12028-024-02201-0","DOIUrl":"https://doi.org/10.1007/s12028-024-02201-0","url":null,"abstract":"<p><strong>Background: </strong>Super-refractory status epilepticus (SRSE) is an extremely serious neurological emergency. Risk factors and mechanisms involved in transition from refractory status epilepticus (RSE) to SRSE are insufficiently studied.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study of consecutive patients diagnosed and treated for RSE at two reference hospital over 5 years in Ecuador. A total of 140 patients were included. Potential demographic, clinical, and treatment variables that may predict progression from refractory to SRSE were analyzed.</p><p><strong>Results: </strong>Super-refractory status epilepticus was identified in 67/140 (48%) of patients. In univariate analyses, level of consciousness on hospital admission (Glasgow Coma Score < 12, odds ratio [OR] 2.9, p < 0.01), traumatic brain injury (OR 2.3, p = 0.05), acute etiology (OR 3.0, p = 0.04), higher Status Epilepticus Severity Score (STESS) (OR 1.7, p < 0.01), and new clinical or electrographic seizure within 6 h (OR 4.2, p < 0.01) of starting anesthetic infusion were important factors related to super-refractory disease. The best independents predictors of SRSE when the presence of other potential factors were considered for multivariate analysis. Two models were calculated to avoid interactions between similar variables. Glasgow Coma Score on hospital admission < 12 (OR 3.1 [95% confidence interval {CI} 1.16-8.29], p = 0.02) and new clinical or electroencephalography (EEG) seizure after first 6 h of starting anesthetic infusion (OR 3.1 [95% CI 1.36-7.09], p = 0.01) were associated with higher risk of progression to SRSE in model 1. In contrast, model 2 indicated that patients with STESS ≥ 3 points (OR 2.9 [95% CI 1.24-6.65], p = 0.01) and new clinical or EEG seizure after 6 h starting anesthetic infusion (OR 3.0 [95% CI 1.32-6.97], p = 0.01) were the factors independently related to super-refractory disease.</p><p><strong>Conclusions: </strong>The rate of patients with RSE admitted to intensive care units developing SRSE was high. Low level of consciousness on admission, higher STESS scores, and patients who did not achieve total control of clinical or EEG seizure in the first 6 h of starting intravenous anesthetic infusion may be early indicators of SRSE.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative Care Spiritual Assessment and Goals-of-Care Discussions in the Neurocritical Care Unit: Collaborating with Chaplains.","authors":"Allison Kestenbaum, Danielle Gilchrist, Brian C Dunlop","doi":"10.1007/s12028-024-02190-0","DOIUrl":"https://doi.org/10.1007/s12028-024-02190-0","url":null,"abstract":"<p><strong>Introduction: </strong>Neuropalliative care is an emerging subspecialty of palliative care designed to address the unique supportive care needs of patients with serious neurological illness, including those receiving neurocritical care in intensive care units. Spiritual care is a vital component in the provision of holistic and humanized care to these patients. A chaplain who is specially trained and credentialed in care for those with serious illness is the health care professional responsible for making spiritual assessments and contributes to the plan of care, facilitating decision making, and guiding other clinicians in the provision of generalist spiritual care.</p><p><strong>Methods: </strong>This article illustrates the role of chaplains in supporting neurocritical care patients and highlights two fundamental aspects of spiritual care: (1) spiritual screening/assessment and (2) assistance with goals-of-care conversations.</p><p><strong>Results: </strong>These cases clarify the role of professionally trained and credentialed chaplains with experience in both neurocritical and palliative care and the value added to the interprofessional team.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"States Do Not Delineate the \"Accepted Medical Standards\" for Brain Death/Death by Neurologic Criteria Determination.","authors":"Dylan Landau, Matthew P Kirschen, David Greer, Ariane Lewis","doi":"10.1007/s12028-024-02209-6","DOIUrl":"https://doi.org/10.1007/s12028-024-02209-6","url":null,"abstract":"<p><strong>Background: </strong>The Uniform Determination of Death Act requires brain death/death by neurologic criteria (BD/DNC) determination to be in accordance with \"accepted medical standards.\" The medical organizations responsible for delineating these guidelines are only specified statutorily in two states. State health organizations (SHOs) are composed of policy experts and medical professionals who are responsible for addressing medical, ethical, and legislative problems related to health. We sought to evaluate information publicly available on SHO websites regarding BD/DNC.</p><p><strong>Methods: </strong>From December 2023 to August 2024, we searched SHO (health department, medical board, medical society, and hospital association) websites for the 48 states without statutory guidance regarding what constitutes accepted medical standards for information regarding BD/DNC using the terms \"brain death,\" \"brain stem,\" and \"determination of death.\" All posts related to BD/DNC were reviewed and categorized via thematic analysis.</p><p><strong>Results: </strong>Of the 192 SHO websites searched, there were 35 from 28 states that provided information regarding BD/DNC: 14 medical societies, 12 health departments, 8 hospital associations, and 1 medical board. Of these 35 SHOs, 12 referenced the state's legal statute, 11 referenced hospital/state/model policies or guidance, 3 referenced both legal statutes and hospital/state/model policies or guidelines, 3 referenced explicit support for standardized BD/DNC guidelines, and 6 made other mention of BD/DNC. New York was the only state with an SHO that provided clear guidance regarding accepted medical standards for BD/DNC determination.</p><p><strong>Conclusions: </strong>For most states, the accepted medical standards for BD/DNC determination are not identified on SHO websites or statutorily. This contributes to inconsistencies across hospital BD/DNC determination policies, leading to medical, ethical, and legal challenges. Delineation of the accepted medical standards for BD/DNC determination in each state could help facilitate consistency and accuracy in BD/DNC determination, prevent false positive determinations of death, and promote public trust in BD/DNC determination and the medical system overall.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Celecoxib Actually Reduce Mortality in Patients with Spontaneous Intracerebral Hemorrhage?","authors":"Ravi Garg","doi":"10.1007/s12028-025-02213-4","DOIUrl":"https://doi.org/10.1007/s12028-025-02213-4","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemoglobin Decrements are Associated with Ischemic Brain Lesions and Poor Outcomes in Patients with Intracerebral Hemorrhage.","authors":"Fernanda Carvalho Poyraz, Christina P Rossitto, Mohamed Ridha, Marialaura Simonetto, Aditya Kumar, Evan Hess, Emma White, Eric Mao, Laura Sieh, Shivani Ghoshal, Sachin Agarwal, Soojin Park, Jan Claassen, E Sander Connolly, J Mocco, Christopher P Kellner, David J Roh","doi":"10.1007/s12028-024-02206-9","DOIUrl":"https://doi.org/10.1007/s12028-024-02206-9","url":null,"abstract":"<p><strong>Background: </strong>Acute ischemic lesions seen on brain magnetic resonance imaging (MRI) are associated with poor intracerebral hemorrhage (ICH) outcomes, but drivers for these lesions are unknown. Rapid hemoglobin decrements occur in the initial days after ICH and may impair brain oxygen delivery. We investigated whether acute hemoglobin decrements after ICH are associated with MRI ischemic lesions and poor long-term ICH outcomes.</p><p><strong>Methods: </strong>Consecutive patients with acute spontaneous ICH enrolled into a single-center prospective cohort study were assessed. Change in hemoglobin levels from admission to brain MRI was defined as the exposure variable. The presence of MRI ischemic lesions on diffusion-weighted imaging was the primary radiographic outcome. Poor 6-month modified Rankin Scale score (4-6) was assessed as our clinical outcome. Separate regression models assessed relationships between exposure and outcomes adjusting for relevant confounders. These relationships were also assessed in a separate prospective single-center cohort of patients with ICH receiving minimally invasive hematoma evacuation.</p><p><strong>Results: </strong>Of 190 patients analyzed in our primary cohort, the mean age was 66.7 years, the baseline hemoglobin level was 13.4 g/dL, and 32% had MRI ischemic lesions. Greater hemoglobin decrements were associated with MRI ischemic lesions (adjusted odds ratio [OR] 0.77 for every 1 g/dL change, 95% confidence interval [CI] 0.60-0.99) and with poor 6-month outcomes (adjusted OR 0.73, 95% CI 0.55-0.98) after adjusting for demographics, ICH and medical disease severity, and antithrombotic use. In our separate cohort of 172 surgical patients with ICH, greater hemoglobin concentration decrements similarly associated with MRI ischemic lesions (adjusted OR 0.74, 95% CI 0.56-0.97) and poor 6-month outcomes (adjusted OR 0.69, 95% CI 0.48-0.98).</p><p><strong>Conclusions: </strong>Greater hemoglobin decrements after acute ICH are associated with ischemic lesions on brain MRI and poor long-term outcomes. Further work is required to clarify drivers for these relationships and whether anemia treatment and prevention can be used to improve ICH outcomes.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety Analysis of Visual Percutaneous Tracheostomy in Neurocritical Care Patients with Anticoagulation and Antithrombosis.","authors":"Xiaopeng Guo, Qinfeng Han, Qian Chen, Min Shan, Ruifang She, Kun Yang","doi":"10.1007/s12028-024-02191-z","DOIUrl":"https://doi.org/10.1007/s12028-024-02191-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the safety of visual percutaneous tracheostomy (vPDT) in neurologic intensive care unit (NICU) patients who are under anticoagulant and antithrombotic therapy.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 54 NICU patients who underwent vPDT at Tai'an Central Hospital from September 2022 to September 2023. The cohort included 36 men and 18 women aged 36-90 years (mean age 62.24 ± 12.24 years). Patients were divided into two groups based on their treatment: an anticoagulant and antithrombotic group (22 patients) and a non-anticoagulant and non-antithrombotic group (32 patients). Clinical data, including demographic information, comorbidities, Glasgow Coma Scale (GCS) score before vPDT, time from NICU admission to vPDT, laboratory indicators, and vPDT complications, were analyzed.</p><p><strong>Results: </strong>The incidence of vPDT complications in the anticoagulant and antithrombotic group was 18.2%, involving three cases of minor intraoperative bleeding and one case of posterior airway wall injury. The non-anticoagulant and non-antithrombotic group had an 18.8% complication rate, including four cases of minor intraoperative bleeding, one case of subcutaneous emphysema with local infection, and one unrelated death. No significant difference in vPDT complications was observed between the two groups (P > 0.05). However, the anticoagulant and antithrombotic group had a higher average age, higher GCS scores, and longer time intervals from NICU admission to vPDT and from intubation to vPDT (all P < 0.05).</p><p><strong>Conclusion: </strong>vPDT appears to be a safe and feasible procedure for NICU patients receiving anticoagulant and antithrombotic therapy, with no significant increase in complications compared to those not on such therapies.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Support Needs and Preferences Among Family Caregivers of ICU Patients with Severe Acute Brain Injury: A Qualitative Thematic Analysis.","authors":"David Y Hwang, Mira Reichman, Sarah M Bannon, Kate Meurer, Rina Kubota, Jisoo Kim, Nithyashri Baskaran, Qiang Zhang, Nathan S Fishbein, Kaitlyn Lichstein, Alexander M Presciutti, Emily C Woodworth, Melissa Motta, Susanne Muehlschlegel, Michael E Reznik, Matthew N Jaffa, Claire J Creutzfeldt, Corey R Fehnel, Amanda D Tomlinson, Craig A Williamson, Ana-Maria Vranceanu","doi":"10.1007/s12028-024-02202-z","DOIUrl":"https://doi.org/10.1007/s12028-024-02202-z","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers of patients with severe acute brain injury (SABI) are at risk for clinically significant chronic emotional distress, including depression, anxiety, and posttraumatic stress. Existing psychosocial interventions for caregivers of intensive care unit (ICU) patients are not tailored to the unique needs of caregivers of patients with SABI, do not demonstrate long-term efficacy, and may increase caregiver burden. In this study, we explored the needs and preferences for psychosocial services among SABI caregivers to inform the development and adaptation of interventions to reduce their emotional distress during and after their relative's ICU admission.</p><p><strong>Methods: </strong>In this multicenter longitudinal qualitative study, we conducted semistructed interviews with SABI caregivers at two time points: during their relative's ICU admission (n = 30) and 2 months later (n = 20). We analyzed qualitative data using a hybrid of inductive and deductive analytic techniques. We recruited family caregivers of patients with SABI from 14 US neuroscience ICUs. We conducted interviews over live video. Our convenience sample of SABI caregivers (n = 30) was recruited through referral by medical teams and nursing staffs across participating neuroscience ICUs. Caregivers included spouses, children, parents, and siblings to patients with SABI.</p><p><strong>Results: </strong>We identified themes and subthemes related to participants' preferences for (1) the content of psychosocial support services and (2) the delivery and implementation of psychosocial support services. Findings revealed an unmet need for psychosocial support around the time of ICU discharge and 2 months later, including information to understand their loved one's condition and guide difficult decision-making, education regarding how best to communicate with the patient's care team and other family members, and emotional and behavioral coping skills.</p><p><strong>Conclusions: </strong>Our findings provide specific recommendations to justify and inform the development and adaptation of psychosocial support services for SABI caregivers for delivery in the ICU and after discharge.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}