Neurointensive Care Monitoring for Severe Traumatic Brain Injury

Idris, Zamzuri; Mustapha, Muzaimi; Abdullah, Jafri Malin

doi:10.5772/28422

Cited by 4 publications

(5 citation statements)

References 83 publications

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“…Besides, our new method of cooling did give the optimal redox range for the focal brain oxygenation (PtiO 2 ): 17.94– 32.44 mmHg which is within the best redox regulation between hypoxemia and hyperoxemia for the brain tissues (15–35 mmHg). [ 11 , 13 , 21 ] Similarly, the range values for the brain temperature in this group are <38°C and higher than 34°C (35.18–37.09°C with a mean of 36.23°C) which is within the recommended functional values for the brain temperature. The normal and well functional brain has a fluctuant temperature that falls within the range of 35.4–38.4°C (36.9±0.5–1.5°C).…”

Section: Resultssupporting

confidence: 61%

Clinical outcomes and thermodynamics aspect of direct brain cooling in severe head injury

Idris

Yee

Hassan

et al. 2023

Surgical Neurology International

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Background: Brain cooling therapy is one of the subjects of interest, and currently, data on direct brain cooling are lacking. Hence, the objective is to investigate the clinical outcomes and discuss the thermodynamics aspect of direct brain cooling on severely injured brain patients. Methods: This pilot study recruited the severely injured brain patients who were then randomized to either a direct brain cooling therapy group using a constant cooling temperature system or a control group. All studied patients must be subjected to an emergency neurosurgical procedure of decompressive craniectomy and were monitored with intracranial pressure, brain oxygenation, and temperature. Further, comparison was made with our historical group of patients who had direct brain cooling therapy through the old technique. Results: The results disclosed the direct brain cooling treated patients through a newer technique obtained a better Extended Glasgow Outcome Score than a control group (P < 001). In addition, there is a significant outcome difference between the combined cooling treated patients (new and old technique) with the control group (P < 0.001). Focal brain oxygenation and temperature are likely factors that correlate with better outcomes. Conclusion: Direct brain cooling is feasible, safe, and affects the clinical outcomes of the severely traumatized brain, and physics of thermodynamics may play a role in its pathophysiology.

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Section: Resultssupporting

confidence: 61%

Clinical outcomes and thermodynamics aspect of direct brain cooling in severe head injury

Idris

Yee

Hassan

et al. 2023

Surgical Neurology International

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“…Compensatory mechanisms exist to maintain intracranial volume homeostasis by extrusion of the CSF or venous blood, in order to preserve ICC, otherwise, these efforts may be insufficient in pathological conditions (i.e. traumatic brain injury) with intracranial hypertension (ICH) and ICC impairment producing primary or secondary brain tissue damage [19,20].…”

Section: Intracranial Pressure-waveform Pathophysiology 31 Waveform mentioning

confidence: 99%

Intracranial Pressure Waveform: History, Fundamentals and Applications in Brain Injuries

Frigieri¹,

Hayashi²,

Rabelo³

et al. 2021

Advancement and New Understanding in Brain Injury

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Intracranial pressure (ICP) can be analyzed for its absolute value, usually in mmHg or cmH2O, its tendency over time and the waveform of its pulse. This chapter will focus on the waveform of the ICP pulse (ICPwf), already observed since 1881, and for a long time not understood. Studies conducted in recent decades show the correlation between the ICPwf and intracranial compliance (ICC), another important clinical parameter added to the practice in the second half of the last century. ICC allows physicians early analyzing patients’ neurological conditions related to disorders resulting from variations in cerebrospinal fluid (CSF), blood and intracranial tissue volumes. This chapter is an invitation to dive into the history and development of ICPwf analysis, clinical uses already adopted and others still under study.

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“…coupled with EEG subdural strip electrodes which detect clinical seizure onset, as shown in Figure 1B [13][14][15]. The probe shown in Figure 1D consists of two small thermistors (neutral and heated) of 24-k gold plates, and monitors the CBF using Saber 2000 Monitor (Flowtronics, Phoenix, AZ), as shown in Figure 2B [36]. The heated sensor measures a cortical area of approximately 1 cm deep in the cerebral hemisphere and 3 cm by implication [36].…”

Section: Cerebral Blood Flow Measurement By Thermal Diffusion Flowmetmentioning

confidence: 99%

“…The probe shown in Figure 1D consists of two small thermistors (neutral and heated) of 24-k gold plates, and monitors the CBF using Saber 2000 Monitor (Flowtronics, Phoenix, AZ), as shown in Figure 2B [36]. The heated sensor measures a cortical area of approximately 1 cm deep in the cerebral hemisphere and 3 cm by implication [36]. Bowman Perfusion Monitor and Saber 2000 are the only two bedside devices commercially available for CBF recording at present.…”

Section: Cerebral Blood Flow Measurement By Thermal Diffusion Flowmetmentioning

confidence: 99%

“…Several studies have analyzed the nonlinear relationship between the electric heating power and blood perfusion [35,[37][38][39][40][41][42][43][44][45][46][47] using the bioheat transfer equation introduced by Pennes [48]. For both isocaloric and isothermal arrangements, assuming that the thermistor is a spherical bead with a radius R s (Figure 3), self-heated (with internal heat generation), and in perfect thermal contact with the surrounding tissue, and no major vessels in the thermal field of influence around the thermistor, the heat transfer equations for a thermistor embedded in a perfused tissue based on a coupled thermal model [35][36][37][38][39][40][41][42][43][44][45][46][47] are:…”

Section: Cerebral Blood Flow Measurement By Thermal Diffusion Flowmetmentioning

confidence: 99%

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Epileptic Seizure Detection and Prediction Based on Continuous Cerebral Blood Flow Monitoring – a Review

Tewolde

Oommen

Lie³

et al. 2000

Journal of Healthcare Engineering

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Epilepsy is the third most common neurological illness, affecting 1% of the world's population. Despite advances in medicine, about 25 to 30% of the patients do not respond to or cannot tolerate the severe side effects of medical treatment, and surgery is not an option for the majority of patients with epilepsy. The objective of this article is to review the current state of research on seizure detection based on cerebral blood flow (CBF) data acquired by thermal diffusion flowmetry (TDF), and CBF-based seizure prediction. A discussion is provided on the applications, advantages, and disadvantages of TDF in detecting and localizing seizure foci, as well as its role in seizure prediction. Also presented are an overview of the present challenges and possible future research directions (along with methodological guidelines) of the CBF-based seizure detection and prediction methods.

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Neurointensive Care Monitoring for Severe Traumatic Brain Injury

Cited by 4 publications

References 83 publications

Clinical outcomes and thermodynamics aspect of direct brain cooling in severe head injury

Clinical outcomes and thermodynamics aspect of direct brain cooling in severe head injury

Intracranial Pressure Waveform: History, Fundamentals and Applications in Brain Injuries

Epileptic Seizure Detection and Prediction Based on Continuous Cerebral Blood Flow Monitoring – a Review

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