Consensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.
Consensus summary statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: a statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine.
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DOI：
10.1007/s12028-014-0041-5
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发表时间：
2014-12
影响因子：
3.5
通讯作者：
中科院分区：
文献类型：
--
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神经危重症的护理在一定程度上依赖于对患者的仔细监测，但迄今为止，关于哪些过程最需要监测，如何监测，以及监测这些过程是否具有成本效益和影响结果的数据很少。与此同时，生物信息学在重症监护中是一个迅速兴起的领域，但迄今为止，关于什么信息重要以及如何显示和分析这些信息，几乎没有达成一致或标准化。神经危重症护理学会与欧洲重症医学学会、重症医学学会和拉丁美洲脑损伤协会合作，组织了一次国际多学科共识会议，开始解决这些需求。来自神经外科、神经危重症护理、神经病学、危重症护理、神经麻醉学、护理学、药学和信息学的国际专家根据他们的研究、出版记录和专业知识被招募。他们进行了系统的文献综述，以制定对需要神经危重症护理的患者重要的生理过程护理的具体主题的建议。本综述未对治疗、影像学和术中监测提出建议。一个多学科的评审团，根据他们在临床调查和实践指南制定方面的专业知识选出，指导这一过程。GRADE系统用于根据文献综述、讨论、将文献与参与者的集体经验相结合以及公正陪审团的批判性审查来制定建议。强调的原则是，建议应以数据质量和权衡以及转化为临床实践为基础。即使在缺乏高质量数据的情况下，也强烈考虑为床边神经监测提供实用的指导和建议。
Neurocritical care depends, in part, on careful patient monitoring but as yet there are little data on what processes are the most important to monitor, how these should be monitored, and whether monitoring these processes is cost-effective and impacts outcome. At the same time, bioinformatics is a rapidly emerging field in critical care but as yet there is little agreement or standardization on what information is important and how it should be displayed and analyzed. The Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine, and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to begin to address these needs. International experts from neurosurgery, neurocritical care, neurology, critical care, neuroanesthesiology, nursing, pharmacy, and informatics were recruited on the basis of their research, publication record, and expertise. They undertook a systematic literature review to develop recommendations about specific topics on physiologic processes important to the care of patients with disorders that require neurocritical care. This review does not make recommendations about treatment, imaging, and intraoperative monitoring. A multidisciplinary jury, selected for their expertise in clinical investigation and development of practice guidelines, guided this process. The GRADE system was used to develop recommendations based on literature review, discussion, integrating the literature with the participants’ collective experience, and critical review by an impartial jury. Emphasis was placed on the principle that recommendations should be based on both data quality and on trade-offs and translation into clinical practice. Strong consideration was given to providing pragmatic guidance and recommendations for bedside neuromonitoring, even in the absence of high quality data.