Multimodality Monitoring in the Neurocritical Care Unit.
Multimodality Monitoring in the Neurocritical Care Unit.
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DOI：
10.1212/con.0000000000000671
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发表时间：
2018-12-01
期刊：
影响因子：
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通讯作者：
Puttgen, Hans Adrian
中科院分区：
文献类型：
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作者：
Rivera Lara, Lucia;Puttgen, Hans Adrian
综述目的：本文重点介绍神经重症监护病房中可用于收集床边数据的多种神经监测设备，以及将其集成到多模式监测系统中的方法。本文描述了如何应用收集的数据来了解生理变化并制定治疗方法以预防继发性损伤。研究结果：神经学检查已成为神经重症监护病房患者继发性脑损伤的主要监测手段。然而，神经危重护理多模式监测国际多学科共识会议的结论是，频繁的床边检查不足以发现和预防继发性脑损伤，与单独的临床检查相比，将多模式监测与先进的信息学工具相结合将极有可能增强我们的评估。本文综述了用于监测局灶性和全局性神经生理性脑部改变的有创和非侵入性技术。仍然需要研究建立更先进的生物信息学监测，以从收集的数据中识别有用的趋势，以预测临床结果或预防继发性脑损伤。
PURPOSE OF REVIEW: This article focuses on the multiple neuromonitoring devices that can be used to collect bedside data in the neurocritical care unit and the methodology to integrate them into a multimodality monitoring system. The article describes how to apply the collected data to appreciate the physiologic changes and develop therapeutic approaches to prevent secondary injury.RECENT FINDINGS: The neurologic examination has served as the primary monitor for secondary brain injury in patients admitted to the neurocritical care unit. However, the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care concluded that frequent bedside examinations are not sufficient to detect and prevent secondary brain injury and that integration of multimodality monitoring with advanced informatics tools will most likely enhance our assessments compared to the clinical examinations alone. This article reviews the invasive and noninvasive technologies used to monitor focal and global neurophysiologic cerebral alterations.SUMMARY: Multimodal monitoring is still in the early stages of development. Research is still needed to establish more advanced monitors with the bioinformatics to identify useful trends from data gathered to predict clinical outcome or prevent secondary brain injury.