Non-Invasive Techniques for Multimodal Monitoring in Traumatic Brain Injury: Systematic Review and Meta-Analysis

Roldán, María Teresa Milanés; Abay, Tomas Ysehak; Kyriacou, P. A.

doi:10.1089/neu.2020.7266

Cited by 32 publications

(25 citation statements)

References 41 publications

(116 reference statements)

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“…Thereafter, Sharawat et al [28] assured the use of TCD as a non-invasive diagnostic modality for increased ICP and using Pearson correlation coefficient found the coefficients for optic nerve sheath diameter, pulsatility index, and resistive index were 0.98, 0.914, and 0.833, respectively. Moreover, Roldán et al [29] conducted a meta-analysis for the most effective techniques for the non-invasive multimodal monitoring for traumatic brain injury and concluded that the near-infrared spectroscopy and TCD are the two most prominent and widely used technologies for non-invasive monitoring in TBI.…”

Section: Discussionmentioning

confidence: 99%

The Role of Transcranial Grayscale and Doppler Ultrasound Examination in Diagnosis of Neonatal Hypoxic-ischemic Encephalopathy

hemeda

Aly²,

Al-Ghannam³

2022

The Egyptian Journal of Hospital Medicine

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Background: The role of transcranial grayscale ultrasound (TC-GSUS) and transcranial color Doppler (TCD) in the diagnosis and prognosis of neonatal hypoxic-ischemic encephalopathy (HIE) is still questionable. Objective: This study targeted to evaluate the role of TC-GSUS and TCD in diagnosis and prediction of the outcome of neonates with suspected HIE in comparison to Sarnat's clinical scoring. Patients and methods: 26 neonates with suspected HIE were clinically evaluated and the severity of HIE was categorized according to Sarnat's clinical staging. Then, all neonates underwent sonographic examinations. TC-GSUS was performed at levels of anterior, mastoid, and posterior fontanelles and the level of the temporal window. Results: Cranial biometry had negative and positive rates for HIE of 7.7% and 92.3%, respectively. Using TC-GSUS, periventricular leukomalacia, intraventricular hemorrhage, brain edema, and hydrocephalus were detected in 17, 19, 14, and 16 patients, respectively. According to the resistive index (RI) of intracranial vessels, TCD excluded HIE in 11 patients and assured diagnosis of HIE with varying severity in 15 patients. Five neonates died and four developed neurological affection during follow-up. The outcome was correlated with Sarnat's scoring, ventricular-hemispheric ratio, and abnormalities of RI. Statistical analyses defined severity of HIE as judged by RI as the significant predictor for mortality and abnormal RI of anterior cerebral (ACA) and internal carotid arteries (ICA) are the most significant predictors of outcomes. Conclusion: TCD can diagnose HIE in neonates with high sensitivity and specificity and abnormal RI of ICA and ACA might be used as valuable diagnostic and prognostic tests.

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Section: Discussionmentioning

confidence: 99%

The Role of Transcranial Grayscale and Doppler Ultrasound Examination in Diagnosis of Neonatal Hypoxic-ischemic Encephalopathy

hemeda

Aly²,

Al-Ghannam³

2022

The Egyptian Journal of Hospital Medicine

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“…[8,92] e future research interests will revolve around noninvasive modalities of ICP monitoring that is considerably safer such as transcranial acoustic signal transmission, ultrasonographic assessment of optic nerve sheath diameter, and others (NCT04548596). [29,34,70,79,83,84,94] e timing of ICP monitor placement is a matter of debate. Early ICP monitor placement, defined as within 6 h of admission, was not found to be associated with better mortality rates in neither adult nor pediatric patients.…”

Section: Placing the Icp Monitormentioning

confidence: 99%

“…[ 8 , 92 ] The future research interests will revolve around noninvasive modalities of ICP monitoring that is considerably safer such as transcranial acoustic signal transmission, ultrasonographic assessment of optic nerve sheath diameter, and others (NCT04548596). [ 29 , 34 , 70 , 79 , 83 , 84 , 94 ]…”

Section: Placing the Icp Monitormentioning

confidence: 99%

Initial neurocritical care of severe traumatic brain injury: New paradigms and old challenges

El-Swaify

kamel

Ali

et al. 2022

Surgical Neurology International

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Background: Early neurocritical care aims to ameliorate secondary traumatic brain injury (TBI) and improve neural salvage. Increased engagement of neurosurgeons in neurocritical care is warranted as daily briefings between the intensivist and the neurosurgeon are considered a quality indicator for TBI care. Hence, neurosurgeons should be aware of the latest evidence in the neurocritical care of severe TBI (sTBI). Methods: We conducted a narrative literature review of bibliographic databases (PubMed and Scopus) to examine recent research of sTBI. Results: This review has several take-away messages. The concept of critical neuroworsening and its possible causes is discussed. Static thresholds of intracranial pressure (ICP) and cerebral perfusion pressure may not be optimal for all patients. The use of dynamic cerebrovascular reactivity indices such as the pressure reactivity index can facilitate individualized treatment decisions. The use of ICP monitoring to tailor treatment of intracranial hypertension (IHT) is not routinely feasible. Different guidelines have been formulated for different scenarios. Accordingly, we propose an integrated algorithm for ICP management in sTBI patients in different resource settings. Although hyperosmolar therapy and decompressive craniectomy are standard treatments for IHT, there is a lack high-quality evidence on how to use them. A discussion of the advantages and disadvantages of invasive ICP monitoring is included in the study. Addition of beta-blocker, anti-seizure, and anticoagulant medications to standardized management protocols (SMPs) should be considered with careful patient selection. Conclusion: Despite consolidated research efforts in the refinement of SMPs, there are still many unanswered questions and novel research opportunities for sTBI care.

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“…In consequence, an ideal neuromonitoring system should be continuous, affordable, noninvasive, and suitable for bedside use or in field monitoring (i.e., ambulances) [20]. Since 1977, when near-infrared spectroscopy (NIRS) was first described for monitoring cerebral perfusion and brain oxygenation [21], clinical interest on this optical technology has increased.…”

Section: Introductionmentioning

confidence: 99%

Near-Infrared Spectroscopy (NIRS) in Traumatic Brain Injury (TBI)

Roldán

Kyriacou

2021

Sensors

Self Cite

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Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently impacts an object or when an object pierces the skull and enters brain tissue. Secondary injuries after traumatic brain injury (TBI) can lead to impairments on cerebral oxygenation and autoregulation. Considering that secondary brain injuries often take place within the first hours after the trauma, noninvasive monitoring might be helpful in providing early information on the brain’s condition. Near-infrared spectroscopy (NIRS) is an emerging noninvasive monitoring modality based on chromophore absorption of infrared light with the capability of monitoring perfusion of the brain. This review investigates the main applications of NIRS in TBI monitoring and presents a thorough revision of those applications on oxygenation and autoregulation monitoring. Databases such as PubMed, EMBASE, Web of Science, Scopus, and Cochrane library were utilized in identifying 72 publications spanning between 1977 and 2020 which were directly relevant to this review. The majority of the evidence found used NIRS for diagnosis applications, especially in oxygenation and autoregulation monitoring (59%). It was not surprising that nearly all the patients were male adults with severe trauma who were monitored mostly with continue wave NIRS or spatially resolved spectroscopy NIRS and an invasive monitoring device. In general, a high proportion of the assessed papers have concluded that NIRS could be a potential noninvasive technique for assessing TBI, despite the various methodological and technological limitations of NIRS.

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Non-Invasive Techniques for Multimodal Monitoring in Traumatic Brain Injury: Systematic Review and Meta-Analysis

Cited by 32 publications

References 41 publications

The Role of Transcranial Grayscale and Doppler Ultrasound Examination in Diagnosis of Neonatal Hypoxic-ischemic Encephalopathy

The Role of Transcranial Grayscale and Doppler Ultrasound Examination in Diagnosis of Neonatal Hypoxic-ischemic Encephalopathy

Initial neurocritical care of severe traumatic brain injury: New paradigms and old challenges

Near-Infrared Spectroscopy (NIRS) in Traumatic Brain Injury (TBI)

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