JK
@julianklug.bsky.social
MD. Researcher @unige_en.
Research | Machine Learning | neurovascular care | intensive care enthusiast.
Research | Machine Learning | neurovascular care | intensive care enthusiast.
The more one knows about the technical part of AI and the real world (clinics), and the gap between them, the more one becomes sceptical. As some days, we struggle to even get the basics right, i wonder what we are even trying to do with ai
October 8, 2025 at 7:03 PM
The more one knows about the technical part of AI and the real world (clinics), and the gap between them, the more one becomes sceptical. As some days, we struggle to even get the basics right, i wonder what we are even trying to do with ai
👨💻 As always, we're committed to #opensource.
You can access all our code here: github.com/JulianKlug/n...
Questions? Let’s discuss ! ⬇️
You can access all our code here: github.com/JulianKlug/n...
Questions? Let’s discuss ! ⬇️
GitHub - JulianKlug/NeuroPyro: A study of the effect of antipyretics on cerebral perfusion and oxygenation in the neurocritically ill
A study of the effect of antipyretics on cerebral perfusion and oxygenation in the neurocritically ill - JulianKlug/NeuroPyro
github.com
May 13, 2025 at 8:45 PM
👨💻 As always, we're committed to #opensource.
You can access all our code here: github.com/JulianKlug/n...
Questions? Let’s discuss ! ⬇️
You can access all our code here: github.com/JulianKlug/n...
Questions? Let’s discuss ! ⬇️
Thanks to a great international team from 🇨🇭🇫🇷🇩🇪 !
May 13, 2025 at 8:45 PM
Thanks to a great international team from 🇨🇭🇫🇷🇩🇪 !
Ultimately, clinicians must balance permissive PtO₂ variability to optimize fever control with diclofenac against the adverse effects of device-based interventions or the risks of sustained hyperthermia ⚖️
🧵(8/n)
🧵(8/n)
May 13, 2025 at 8:45 PM
Ultimately, clinicians must balance permissive PtO₂ variability to optimize fever control with diclofenac against the adverse effects of device-based interventions or the risks of sustained hyperthermia ⚖️
🧵(8/n)
🧵(8/n)
This decrease in PtO2 is less pronounced than with short infusion protocols and the clinical relevance of such a small decrease is questionable 🤷♂️
🧵(7/n)
🧵(7/n)
May 13, 2025 at 8:45 PM
This decrease in PtO2 is less pronounced than with short infusion protocols and the clinical relevance of such a small decrease is questionable 🤷♂️
🧵(7/n)
🧵(7/n)
We found:
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
May 13, 2025 at 8:45 PM
We found:
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
We thus investigated 39 administrations of 12h diclofenac infusions in 18 febrile patients with acute brain injury AND brain tissue oxygenation monitoring 🫧 - comparing pre vs. post 🧠-status
🧵(6/n)
🧵(6/n)
May 13, 2025 at 8:45 PM
We thus investigated 39 administrations of 12h diclofenac infusions in 18 febrile patients with acute brain injury AND brain tissue oxygenation monitoring 🫧 - comparing pre vs. post 🧠-status
🧵(6/n)
🧵(6/n)
This has lead to the use of extended (12h ⏰) or continuous (days 🗓️) diclofenac infusion protocols -
but their effect on cerebral oxygenation has never been verified
🧵(5/n)
but their effect on cerebral oxygenation has never been verified
🧵(5/n)
May 13, 2025 at 8:45 PM
This has lead to the use of extended (12h ⏰) or continuous (days 🗓️) diclofenac infusion protocols -
but their effect on cerebral oxygenation has never been verified
🧵(5/n)
but their effect on cerebral oxygenation has never been verified
🧵(5/n)
IV diclofenac bolus infusions have been shown to reduce temperature ⬇️, but have been associated with a decrease in brain oxygenation and CPP
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
May 13, 2025 at 8:45 PM
IV diclofenac bolus infusions have been shown to reduce temperature ⬇️, but have been associated with a decrease in brain oxygenation and CPP
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
💊Pharmacological options are limited and depend on the country, but include: paracetamol, metamizole and NSAIDs
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
May 13, 2025 at 8:45 PM
💊Pharmacological options are limited and depend on the country, but include: paracetamol, metamizole and NSAIDs
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
Fever 🔥 occurs frequently after acute brain injury, such as intracranial haemorrhage, stroke or traumatic brain injury 🤯 - but even small temperature elevations are associated with worse prognosis!
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
May 13, 2025 at 8:45 PM
Fever 🔥 occurs frequently after acute brain injury, such as intracranial haemorrhage, stroke or traumatic brain injury 🤯 - but even small temperature elevations are associated with worse prognosis!
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
But then again probably the right population to test it in, as anymore severe than that ie stage D/E, more flow would be required
April 1, 2025 at 3:46 PM
But then again probably the right population to test it in, as anymore severe than that ie stage D/E, more flow would be required
Mostly stage B and C is probably just not severe enough
April 1, 2025 at 3:39 PM
Mostly stage B and C is probably just not severe enough
Great thread and summary of current state of the evidence! Any idea why they only did a dichotomized analysis of the mrs though?
December 11, 2024 at 6:45 AM
Great thread and summary of current state of the evidence! Any idea why they only did a dichotomized analysis of the mrs though?
Totally on your side for that one
December 4, 2024 at 4:15 PM
Totally on your side for that one
What study are you referring to?
December 4, 2024 at 11:27 AM
What study are you referring to?
Was wondering the same thing - What goal of cardiac output is one aiming for? And we already know that supranormal is harmful...
December 3, 2024 at 7:47 PM
Was wondering the same thing - What goal of cardiac output is one aiming for? And we already know that supranormal is harmful...
December 3, 2024 at 7:35 PM