儿童无创神经监测方式 第一部分：瞳孔测量法、近红外光谱法和经颅多普勒超声检查法
Noninvasive Neuromonitoring Modalities in Children Part I: Pupillometry, Near-Infrared Spectroscopy, and Transcranial Doppler Ultrasonography.
作者信息
Lovett Marlina E, MacDonald Jennifer M, Mir Marina, Ghosh Suman, O'Brien Nicole F, LaRovere Kerri L
机构信息
Division of Critical Care Medicine, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.
Division of Pediatric Critical Care, Montreal Children's Hospital and McGill University, Montreal, Canada.
出版信息
Neurocrit Care. 2024 Feb;40(1):130-146. doi: 10.1007/s12028-023-01730-4. Epub 2023 May 9.
BACKGROUND
Noninvasive neuromonitoring in critically ill children includes multiple modalities that all intend to improve our understanding of acute and ongoing brain injury.
METHODS
In this article, we review basic methods and devices, applications in clinical care and research, and explore potential future directions for three noninvasive neuromonitoring modalities in the pediatric intensive care unit: automated pupillometry, near-infrared spectroscopy, and transcranial Doppler ultrasonography.
RESULTS
All three technologies are noninvasive, portable, and easily repeatable to allow for serial measurements and trending of data over time. However, a paucity of high-quality data supporting the clinical utility of any of these technologies in critically ill children is currently a major limitation to their widespread application in the pediatric intensive care unit.
CONCLUSIONS
Future prospective multicenter work addressing major knowledge gaps is necessary to advance the field of pediatric noninvasive neuromonitoring.
背景
危重症儿童的无创神经监测包括多种方式，所有这些方式都旨在增进我们对急性和持续性脑损伤的理解。
方法
在本文中，我们回顾了基本方法和设备、在临床护理与研究中的应用，并探讨了儿科重症监护病房中三种无创神经监测方式的潜在未来发展方向：自动瞳孔测量法、近红外光谱法和经颅多普勒超声检查。
结果
这三种技术均为无创、便携且易于重复，以便进行连续测量和随时间的数据趋势分析。然而，目前缺乏高质量数据支持这些技术在危重症儿童中的临床效用，这是它们在儿科重症监护病房广泛应用的主要限制。
结论
未来需要开展前瞻性多中心研究以填补主要知识空白，从而推动儿科无创神经监测领域的发展。
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