Challenges and Opportunities in Multimodal Monitoring and Data Analytics in Traumatic Brain Injury

Abstract

Purpose of Review Increasingly sophisticated systems for monitoring the brain have led to an increase in the use of multimodality monitoring (MMM) to detect secondary brain injuries before irreversible damage occurs after brain trauma. This review examines the challenges and opportunities associated with MMM in this population. Recent Findings Locally and internationally, the use of MMM varies. Practical challenges include difficulties with data acquisition, curation, and harmonization with other data sources limiting collaboration. However, efforts toward integration of MMM data, advancements in data science, and the availability of cloud-based infrastructures are now affording the opportunity for MMM to advance the care of patients with brain trauma. Summary MMM provides data to guide the precision management of patients with traumatic brain injury in real time. While challenges exist, there are exciting opportunities for MMM to live up to this promise and to drive new insights into the physiology of the brain and beyond.

The New Field of Network Physiology: Building the Human Physiolome

“…In addition to the state of individual organ systems, coordinated network interactions among systems and sub-systems are essential to generate distinct physiologic states and behaviors at the organism level, such as wake, sleep and sleep stages, rest and exercise, stress and anxiety, cognition, consciousness and unconsciousness. Disrupting organ communications can lead to dysfunction of individual systems or trigger a cascade of failures leading to a breakdown and collapse of the entire organism, as observed under clinical conditions such as sepsis, coma and multiple organ failure (Buchman, 2006;Moorman et al, 2016;Shashikumar et al, 2017;Foreman et al, 2021). Yet, despite the vast progress and achievements in systems biology and integrative physiology in the last decades, and the importance to basic physiology and clinical practice, we do not know the principles and mechanisms through which diverse systems and sub-systems in the human body dynamically interact as a network and integrate their functions to generate physiological states in health and disease.…”

The pressure reactivity index as a measure of cerebral autoregulation and its application in traumatic brain injury management

“…Calculation of the derived parameters also relies on proprietary software (e.g., Intensive Care Monitor Plus (ICM+) by Cambridge University, or CNS Envision by Moberg ICU Solutions) the use of which is typically a novel step for clinicians, that requires both a high degree of understanding of and confidence in the underlying science. 41 …”

Current state of high-fidelity multimodal monitoring in traumatic brain injury

“…In the future, artificial intelligence (AI) and different machine learning approaches may facilitate the interpretation of multimodal monitoring signals. Currently, this has been shown to improve dynamic predictions in patients monitored using ICP [38] but is still in its infancy when it comes to incorporating several modalities in real time [12]. Most importantly, however, is that just inserting fancy and expensive monitoring equipment will not improve the outcome and management of TBI patients.…”