Invasive Neurological and Multimodality Monitoring in the NeuroICU

Roux, Peter Le

doi:10.1007/978-1-4471-5226-2_8

Cited by 6 publications

(2 citation statements)

References 172 publications

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“…This brings to fore the concept of multi-modality management[155,166-170]. Along with ICP monitor, new-age monitors such as cerebral microdialysis, brain tissue saturation, TCD, cerebral blood flow, EEG as well as routine imaging based monitoring have been explored to monitor neurological injury[171-174]. They are rapidly establishing themselves as a part of multimodality management where in addition to understanding the pathophysiology of ongoing neurological injury and influencing therapeutic decisions, they also have shown promise as independent markers of morbidity and mortality[175-180].…”

Section: Is Icp Monitoring Really Beneficial: What Is the Evidence?mentioning

confidence: 99%

Intracranial pressure monitoring: Gold standard and recent innovations

Nag¹,

Sahu²,

Swain³

et al. 2019

WJCC

147

123

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Intracranial pressure monitoring (ICP) is based on the doctrine proposed by Monroe and Kellie centuries ago. With the advancement of technology and science, various invasive and non-invasive modalities of monitoring ICP continue to be developed. An ideal monitor to track ICP should be easy to use, accurate, reliable, reproducible, inexpensive and should not be associated with infection or haemorrhagic complications. Although the transducers connected to the extra ventricular drainage continue to be Gold Standard, its association with the likelihood of infection and haemorrhage have led to the search for alternate non-invasive methods of monitoring ICP. While Camino transducers, Strain gauge micro transducer based ICP monitoring devices and the Spiegelberg ICP monitor are the emerging technology in invasive ICP monitoring, optic nerve sheath diameter measurement, venous opthalmodynamometry, tympanic membrane displacement, tissue resonance analysis, tonometry, acoustoelasticity, distortion-product oto-acoustic emissions, trans cranial doppler, electro encephalogram, near infra-red spectroscopy, pupillometry, anterior fontanelle pressure monitoring, skull elasticity, jugular bulb monitoring, visual evoked response and radiological based assessment of ICP are the non-invasive methods which are assessed against the gold standard.

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Section: Is Icp Monitoring Really Beneficial: What Is the Evidence?mentioning

confidence: 99%

Intracranial pressure monitoring: Gold standard and recent innovations

Nag¹,

Sahu²,

Swain³

et al. 2019

WJCC

147

123

View full text Add to dashboard Cite

show abstract

“…Second, assessment is confounded by analgesics, sedatives, anesthetics and anticonvulsants, as well as deliberate control of blood pressure, blood gases, acid-base status, plasma osmolality, glucose and temperature (41)(42)(43)(44). Third, intracranial veins can behave as either veins in series without threshold flow characteristics (45), or as a 'Starling Resistor' (6,7). If intrathoracic pressures are transmitted into the intracranial veins, this can increase the volume of intracranial blood (even if only slightly).…”

Section: Injured Brain -Icpmentioning

confidence: 99%

Impact of Altered Airway Pressure on Intracranial Pressure, Perfusion, and Oxygenation: A Narrative Review

Chen

Menon

Kavanagh

2019

Critical Care Medicine

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Objectives: A narrative review of the pathophysiology linking altered airway pressure and intracranial pressure and cerebral oxygenation. Data Sources: Online search of PubMed and manual review of articles (laboratory and patient studies) of the altered airway pressure on intracranial pressure, cerebral perfusion, or cerebral oxygenation. Study Selection: Randomized trials, observational and physiologic studies. Data Extraction: Our group determined by consensus which resources would best inform this review. Data Synthesis: In the normal brain, positive-pressure ventilation does not significantly alter intracranial pressure, cerebral oxygenation, or perfusion. In injured brains, the impact of airway pressure on intracranial pressure is variable and determined by several factors; a cerebral venous Starling resistor explains much of the variability. Negative-pressure ventilation can improve cerebral perfusion and oxygenation and reduce intracranial pressure in experimental models, but data are limited, and mechanisms and clinical benefit remain uncertain. Conclusions: The effects of airway pressure and ventilation on cerebral perfusion and oxygenation are increasingly understood, especially in the setting of brain injury. In the face of competing mechanisms and priorities, multimodal monitoring and individualized titration will increasingly be required to optimize care.

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Managing Clinical Data in Neurocritical Care

Dziedzic

Suárez

2022

Health Informatics

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Invasive Neurological and Multimodality Monitoring in the NeuroICU

Cited by 6 publications

References 172 publications

Intracranial pressure monitoring: Gold standard and recent innovations

Intracranial pressure monitoring: Gold standard and recent innovations

Impact of Altered Airway Pressure on Intracranial Pressure, Perfusion, and Oxygenation: A Narrative Review

Managing Clinical Data in Neurocritical Care

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