Current neuromonitoring techniques in critical care

Ristic, Anette; Sutter, Raoul; Steiner, Luzius A.

doi:10.4103/2348-0548.154234

Cited by 14 publications

(14 citation statements)

References 46 publications

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“…[ 42 ] Measurement of ICP and arterial BP is used to derive CPP and to guide targeted therapy of STBI necessitating ICU admission. [ 43 44 ] Cerebral oxygenation and near-infrared spectroscopy are also established as an important parameter for monitoring. Multimodal monitoring allows different parameters of brain physiology and function to be monitored and can improve identification and prediction of secondary cerebral insults.…”

Section: R Esults and Discussionsmentioning

confidence: 99%

Nursing management of adults with severe traumatic brain injury: A narrative review

Varghese¹,

Chakrabarty²,

Menon³

2017

Indian Journal of Critical Care Medicine

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Effective nursing management strategies for adults with severe traumatic brain injury (STBI) are still a remarkable issue and a difficult task for neurologists, neurosurgeons, and neuronurses. A list of justified indications and scientific rationale for nursing management of these patients are continuously evolving. The objectives of the study are to analyze the pertinently available research and clinical studies that demonstrate the nursing management strategies for adults with STBI and to synthesize the available evidence based on the review. A comprehensive literature search was made in following databases such as Google Scholar, Cochrane, J-Gate, ProQuest, and ScienceDirect for retrieving the related studies. In the included studies, data were extracted and evaluated according to the objective. Narrative analysis was adopted to write this review. Patients with STBI have poor prognosis and require quality care for maximizing patients' survival. With a thorough knowledge and discernment of care of such patients, nurses can improve these patients' neurological outcomes.

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Section: R Esults and Discussionsmentioning

confidence: 99%

Nursing management of adults with severe traumatic brain injury: A narrative review

Varghese¹,

Chakrabarty²,

Menon³

2017

Indian Journal of Critical Care Medicine

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“…Recent studies [5][6][7] have also yielded conflicting results. Invasive ICP measurement is performed by specific catheters, inserted into the intraventricular, intraparenchymal, epidural, subdural or subarachnoid space [8]. The ideal ICP monitoring device should be reliable, accurate, cost-effective and be associated with minimal morbidity.…”

Section: Invasive Icp Monitoringmentioning

confidence: 99%

“…Measurement of PbtO 2 by inserting a microcatheter in the white matter allows to unmask reduced perfusion and insufficient oxygen supply (< 10 mmHg) and also unmasks underlying hyperemia (> 30 mmHg). However, the measurement is regional, as only approximately 15 mm 2 of tissue around the tip is sampled [8]. Current MMM consensus consider PbtO 2 of less than 20 mmHg as threshold to consider intervention [1].…”

Section: Brain Tissue O 2 Partial Pressure (Pbto 2 )mentioning

confidence: 99%

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An overview of management of intracranial hypertension in the intensive care unit

et al. 2020

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Intracranial hypertension (IH) is a clinical condition commonly encountered in the intensive care unit, which requires immediate treatment. The maintenance of normal intracranial pressure (ICP) and cerebral perfusion pressure in order to prevent secondary brain injury (SBI) is the central focus of management. SBI can be detected through clinical examination and invasive and non-invasive ICP monitoring. Progress in monitoring and understanding the pathophysiological mechanisms of IH allows the implementation of targeted interventions in order to improve the outcome of these patients. Initially, general prophylactic measures such as patient's head elevation, fever control, adequate analgesia and sedation depth should be applied immediately to all patients with suspected IH. Based on specific indications and conditions, surgical resection of mass lesions and cerebrospinal fluid drainage should be considered as an initial treatment for lowering ICP. Hyperosmolar therapy (mannitol or hypertonic saline) represents the cornerstone of medical treatment of acute IH while hyperventilation should be limited to emergency management of life-threatening raised ICP. Therapeutic hypothermia could have a possible benefit on outcome. To control elevated ICP refractory to maximum standard medical and surgical treatment, at first, high-dose barbiturate administration and then decompressive craniectomy as a last step are recommended with unclear and probable benefit on outcomes, respectively. The therapeutic strategy should be based on a staircase approach and be individualized for each patient. Since most therapeutic interventions have an uncertain effect on neurological outcome and mortality, future research should focus on both studying the long-term benefits of current strategies and developing new ones.

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“…The most widely used bedside monitoring tool is Intracranial Pressure (ICP) monitoring [ 9 ]. According to different measurement needs, the ICP probe can be inserted into the subdural, cerebral ventricle, and parenchyma [ 10 ]. However, as an invasive method, ICP causes secondary injury to patients, which may adversely affect the prognosis.…”

Section: Introductionmentioning

confidence: 99%

An amplitude-based characteristic parameter extraction algorithm for cerebral edema detection based on electromagnetic induction

Liang

Zhao

et al. 2021

BioMed Eng OnLine

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Background Cerebral edema is a common condition secondary to any type of neurological injury. The early diagnosis and monitoring of cerebral edema is of great importance to improve the prognosis. In this article, a flexible conformal electromagnetic two-coil sensor was employed as the electromagnetic induction sensor, associated with a vector network analyzer (VNA) for signal generation and receiving. Measurement of amplitude data over the frequency range of 1–100 MHz is conducted to evaluate the changes in cerebral edema. We proposed an Amplitude-based Characteristic Parameter Extraction (Ab-CPE) algorithm for multi-frequency characteristic analysis over the frequency range of 1–100 MHz and investigated its performance in electromagnetic induction-based cerebral edema detection and distinction of its acute/chronic phase. Fourteen rabbits were enrolled to establish cerebral edema model and the 24 h real-time monitoring experiments were carried out for algorithm verification. Results The proposed Ab-CPE algorithm was able to detect cerebral edema with a sensitivity of 94.1% and specificity of 95.4%. Also, in the early stage, it can detect cerebral edema with a sensitivity of 85.0% and specificity of 87.5%. Moreover, the Ab-CPE algorithm was able to distinguish between acute and chronic phase of cerebral edema with a sensitivity of 85.0% and specificity of 91.0%. Conclusion The proposed Ab-CPE algorithm is suitable for multi-frequency characteristic analysis. Combined with this algorithm, the electromagnetic induction method has an excellent performance on the detection and monitoring of cerebral edema.

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Current neuromonitoring techniques in critical care

Cited by 14 publications

References 46 publications

Nursing management of adults with severe traumatic brain injury: A narrative review

Nursing management of adults with severe traumatic brain injury: A narrative review

An overview of management of intracranial hypertension in the intensive care unit

An amplitude-based characteristic parameter extraction algorithm for cerebral edema detection based on electromagnetic induction

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