Monitoring of head injured patients

Timofeev, Ivan; Gupta, Arun Kumar

doi:10.1097/01.aco.0000183107.19673.ed

Cited by 14 publications

(13 citation statements)

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“…[1227] It is based on reflectance oximetry and measures the light reflected from chromophobes in the brain (hemoglobin) to derive the regional oxygen saturation (rSO 2 ). It interrogates arterial, venous and capillary blood and hence, the oxygen saturation represents an average value for these compartments.…”

Section: Cerebral Oxygenation Monitoringmentioning

confidence: 99%

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Advances in neuro-monitoring

2013

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Neuromonitoring aims to detect harmful physiologic events, early enough to guide the treatment instituted. Evidences encourage us to implement multimodal monitoring, as no single monitor is capable of providing a complete picture of dynamic cerebral state. This review highlights the role of intracranial pressure monitoring, cerebral oxygenation (jugular venous oximetry, brain tissue oxygenation, near infrared oximetry, cerebral microdialysis) and cerebral blood flow monitoring (direct and indirect methods) in the management of neurologically injured patients. In this context, the recent developments of these monitors along with the relevant clinical implications have been discussed. Nevertheless, the diverse range of data obtained from these monitors needs to be integrated and simplified for the clinician. Hence, the future research should focus on identification of a most useful monitor for integration into multimodal system.

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Section: Cerebral Oxygenation Monitoringmentioning

confidence: 99%

“…[125253] Reasonable correlations have been reported between TCD and Xe CT and PET CBF measurements. [54] It has also found utility for detecting cerebral vasospasm after SAH, for evaluation of autoregulation, for noninvasive estimation of ICP and to confirm brain death.…”

Section: Cbf Monitoringmentioning

confidence: 99%

Advances in neuro-monitoring

2013

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“…Maintaining an optimal level of cerebral oxygenation has long been recognised as an important component of the strategy in the management of TBI 8,9,38 . There is evidence that ischaemia accounts for much of cellular damage in brain injury 8 .…”

Section: Brain Oxygenationmentioning

confidence: 99%

“…However, as mentioned earlier in this article, the use of CPP is highly controversial, attracting much criticism 8 . In addition, monitoring CBF alone may not be enough as there is much heterogeneity in cerebrovascular responses and metabolic demands in both injured and uninjured regions of the brain; areas with high metabolic demand may be ischaemic even with normal CBF, while low CBF may suffice for areas with decreased metabolic demand 9 . Pathologic changes in ICP and CPP are not always responsible for secondary insults to the brain 40 .…”

Section: Brain Oxygenationmentioning

confidence: 99%

Neuromonitoring for Traumatic Brain Injury in Neurosurgical Intensive Care

Lee

Goh

2010

Proceedings of Singapore Healthcare

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The primary aim of neuromonitoring in patients with traumatic brain injury is early detection of secondary brain insults so that timely interventions can be instituted to prevent or treat secondary brain injury. Intracranial pressure monitoring has been a stalwart in neuromonitoring and is still very much the main parameter to guide therapy in brain injured patients in many centres. Cerebral oxygenation is also established as an important parameter for monitoring: global cerebral oxygenation is reliably measured using jugular venous oxygen saturation while brain tissue oxygen tension measurement allows focal brain oxygenation to be monitored. Near-infrared spectroscopy allows a non-invasive option for monitoring of regional cerebral oxygenation. Cerebral microdialysis makes focal measurements of markers of cellular metabolism and cellular injury and death possible, and it is in transition from being a research tool to being an important clinical tool in neuromonitoring. Multimodal monitoring allows different parameters of brain physiology and function to be monitored and can improve identification and prediction of secondary cerebral insults. Multimodal monitoring can potentially improve outcomes in patients with traumatic brain injury by promoting customised treatment strategies for individual patients in place of the commonplace practice of strict adherence to achieving the same standard physiological targets for every patient.

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“…Though there is no doubt that the ICP values or waves are important for preventing or controlling the intracranial high pressure and making sure the therapeutic schedule is correct, the invasive ICP measuring or monitoring methods have not been used widely in clinical because they are invasive, infectious, and need professional person to explain the clinical information [1]. Furthermore, it is expensive to use in clinical.…”

Section: Introductionmentioning

confidence: 99%

A New Noninvasive Intracranial Pressure Measurement Instrument Based upon Multi-parameters Fusion Methods

Peng

2012

2012 International Conference on Biomedical Engineering and Biotechnology

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The paper introduces a new noninvasive intracranial pressure measurement instrument to overcome the shortcomings of invasive intracranial pressure monitoring methods. The instrument was realized by applying the multiparameters features extracted from the signals measured with flash visual evoked potential (FVEP) and transcranial Doppler (TCD) methods synthetically. Clinical application approves its validity.

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Monitoring of head injured patients

Abstract: Multimodality neuromonitoring plays an important role in managing patients with severe head injury. It helps guide treatment, provides prognostic information and explores the pathophysiology of evolving brain injury.

Cited by 14 publications

References 50 publications

Advances in neuro-monitoring

Advances in neuro-monitoring

Neuromonitoring for Traumatic Brain Injury in Neurosurgical Intensive Care

A New Noninvasive Intracranial Pressure Measurement Instrument Based upon Multi-parameters Fusion Methods

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