Multimodality Monitoring in Head Injury

Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy

“…It should be noted that some of these techniques allow clinicians to continuously monitor the brain status (e.g., PbtO 2 , NIRS), while others provide only a snapshot (e.g., CT) [ 139 ]. The combined analysis of these two types of technique can increase its overall accuracy (e.g., duration of an ischemic status) as well as reduce the time to respond [ 49 , 140 ].…”

“…Optical research studies found a correlation between the structural image and the probes’ positions or based the latter upon the position of the lesions seen on the CT scan [ 106 , 148 ]. The position of the tip of the PbtO 2 catheter in the brain must be pinpointed on a CT scan in order to link the values reported with the status of the tissue seen on the structural image [ 139 ]. In much the same way, the NIRS values should be co-registered on patients’ CT scans: to compare the values reported by the two techniques; to avoid inaccuracies and/or misinterpretations due to the heterogeneity of tissue status across the brain; and to guide the probes’ positioning to the regions of interest [ 145 ].…”

“…Thus, by integrating microdialysis into the multimodal monitoring, the metabolic status of the tissue can be better understood [ 150 ]. Similar to PbtO 2 neuromonitoring, the values obtained through microdialysis must be associated with the position of the catheter on the CT scan, and they vary from the other pathophysiological parameters to some degree [ 45 , 139 ].…”