Browsing by Author "Ramaiah, Ramesh"

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    S-100β and Antioxidant Capacity in Cerebrospinal Fluid during and after Thoracic Endovascular Aortic Repair.
    (Int Sch Res Notices, 2017) Nandate, Koichiro; Sharma, Deepak; Olivar, Hernando; Hallman, Matthew; Ramaiah, Ramesh; Joffe, Aaron; Roche, Anthony; Krishnamoorthy, Vijay
    BACKGROUND: Thoracic Endovascular Aortic Repair (TEVAR) has substantially decreased the mortality and major complications from aortic surgery. However, neurological complications such as spinal cord ischemia may still occur after TEVAR. S-100β is a biomarker of central nervous system injury, and oxidant injury plays an important role in neurological injury. In this pilot study, we examined the trends of S-100β and antioxidant capacity in the CSF during and after TEVAR. METHODS: We recruited 10 patients who underwent elective TEVAR. CSF samples were collected through a lumbar catheter at the following time points: before the start of surgery (T0) and immediately (T1) and 24 (T2) and 48 hours (T3) after the deployment of the aortic stent. S-100β and CSF antioxidant capacity were analyzed with the use of commercially available kits. RESULTS: We observed that the level of S-100β in all of the subjects at 24 hours after the deployment of the aortic stent (T2) increased. However, the levels of S-100β at T1 and T3 were comparable to the baseline value. The antioxidant capacity remained unchanged. No patient had a clinical neurologic complication. CONCLUSIONS: Our observations may indicate biochemical/subclinical central nervous system injury attributable to the deployment of the aortic stent.
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    Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma.
    (Int J Crit Illn Inj Sci, 2012-09) Greene, Nathaniel; Bhananker, Sanjay; Ramaiah, Ramesh
    Trauma care in the general population has largely become protocol-driven, with an emphasis on fast and efficient treatment, good team communication at all levels of care including prehospital care, initial resuscitation, intensive care, and rehabilitation. Most available literature on trauma care has focused on adults, allowing the potential to apply concepts from adult care to pediatric care. But there remain issues that will always be specific to pediatric patients that may not translate from adults. Several new devices such as intraosseous (IO) needle systems and techniques such as ultrasonography to cannulate central and peripheral veins have become available for integration into our pre-existing trauma care system for children. This review will focus specifically on the latest techniques and evidence available for establishing intravenous access, rational approaches to fluid resuscitation, and blood product transfusion in the pediatric trauma patient.