Casault Colin, Couillard Philippe, Kromm Julie, Rosenthal Eric, Kramer Andreas, Brindley Peter
Department of Critical Care Medicine, University of Calgary, Calgary, Canada.
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
J Intensive Care Soc. 2022 May;23(2):191-202. doi: 10.1177/1751143720980273. Epub 2020 Dec 14.
Traumatic brain injury (TBI) is common and potentially devastating. Traditional examination-based patient monitoring following TBI may be inadequate for frontline clinicians to reduce secondary brain injury through individualized therapy. Multimodal neurologic monitoring (MMM) offers great potential for detecting early injury and improving outcomes. By assessing cerebral oxygenation, autoregulation and metabolism, clinicians may be able to understand neurophysiology during acute brain injury, and offer therapies better suited to each patient and each stage of injury. Hence, we offer this primer on brain tissue oxygen monitoring, pressure reactivity index monitoring and cerebral microdialysis. This narrative review serves as an introductory guide to the latest clinically-relevant evidence regarding key neuromonitoring techniques.
创伤性脑损伤（TBI）很常见且可能具有毁灭性。TBI后基于传统检查的患者监测可能不足以让一线临床医生通过个体化治疗来减少继发性脑损伤。多模态神经监测（MMM）在检测早期损伤和改善预后方面具有巨大潜力。通过评估脑氧合、自动调节和代谢，临床医生或许能够了解急性脑损伤期间的神经生理学，并提供更适合每个患者和损伤每个阶段的治疗方法。因此，我们提供这本关于脑组织氧监测、压力反应性指数监测和脑微透析的入门指南。这篇叙述性综述作为有关关键神经监测技术的最新临床相关证据的入门指南。
