Multimodality Monitoring in the Neurointensive Care Unit: A Special Perspective for Patients with Stroke
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Multimodality monitoring (MMM) is a recently developed method that aids in understanding real-time brain physiology. Early detection of physiological disturbances is possible with the help of MMM, which allows identification of underlying causes of deterioration and minimization of secondary brain injury (SBI). MMM is especially helpful in comatose patients with severe brain injury because neurological examinations are not sensitive enough to detect SBI. The variables frequently examined in MMM are hemodynamic parameters such as intracranial pressure, cerebral perfusion pressure, and mean arterial pressure; brainspecific oxygen tension; markers for brain metabolism including glucose, lactate, and pyruvate levels in brain tissue; and cerebral blood flow. Continuous electroencephalography can be performed, if needed. The majority of SBIs stem from brain tissue hypoxia, brain ischemia,and seizures, which lead to a disturbance in brain oxygen levels, cerebral blood flow,and electrical discharges, all of which are easily detected by MMM. In this review, we discuss the clinical importance of physiological variables as well as the practical applicability of MMM in patients with stroke.
Abstract
Multimodality monitoring (MMM) is a recently developed method that aids in understanding real-time brain physiology. Early detection of physiological disturbances is possible with the help of MMM, which allows identification of underlying causes of deterioration and minimization of secondary brain injury (SBI). MMM is especially helpful in comatose patients with severe brain injury because neurological examinations are not sensitive enough to detect SBI. The variables frequently examined in MMM are hemodynamic parameters such as intracranial pressure, cerebral perfusion pressure, and mean arterial pressure; brainspecific oxygen tension; markers for brain metabolism including glucose, lactate, and pyruvate levels in brain tissue; and cerebral blood flow. Continuous electroencephalography can be performed, if needed. The majority of SBIs stem from brain tissue hypoxia, brain ischemia,and seizures, which lead to a disturbance in brain oxygen levels, cerebral blood flow,and electrical discharges, all of which are easily detected by MMM. In this review, we discuss the clinical importance of physiological variables as well as the practical applicability of MMM in patients with stroke.
참고문헌 (45)
- Kramer AH, "Do neurocritical care units save lives? Measuring the impact of specialized ICUs", Neurocrit Care, 14, pp.329~333 (2011)
- Wright WL, "Multimodal monitoring in the ICU: when could it be useful?", J Neurol Sci, 261, pp.10~15 (2007)
- Sahuquillo J., "Does multimodality monitoring make a difference in neurocritical care?", Eur J Anaesthesiol, 42, pp.83~86 (2008)
- Hemphill JC, "Multimodal monitoring and neurocritical care bioinformatics", Nat Rev Neurol, 7, pp.451~460 (2011)
- Le Roux P, "Physiological monitoring of the severe traumatic brain injury patient in the intensive care unit", Curr Neurol Neurosci Rep, 13, pp.331~ (2013)
- Feyen BF, "Neuromonitoring in traumatic brain injury", Minerva Anestesiol, 78, pp.949~958 (2012)
- Schmidt JM, "Cerebral perfusion pressure thresholds for brain tissue hypoxia and metabolic crisis after poor-grade subarachnoid hemorrhage", Stroke, 42, pp.1351~1356 (2011)
- Ko SB, "Multimodality monitoring for cerebral perfusion pressure optimization in comatose patients with intracerebral hemorrhage", Stroke, 42, pp.3087~3092 (2011)
- Ko SB, "Status epilepticus-induced hyperemia and brain tissue hypoxia after cardiac arrest", Arch Neurol, 68, pp.1323~1326 (2011)
- Stuart RM, "Intracranial multimodal monitoring for acute brain injury: a single institution review of current practices", Neurocrit Care, 12, pp.188~198 (2010)
- Stern WE, "Intracranial fluid dynamics: the relationship of intracranial pressure to the monro-kellie doctrine and the reliability of pressure assessment", J R Coll Surg Edinb, 9, pp.18~36 (1963)
- Jauch EC, "Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2013, pp.44, 870~947
- Morgenstern LB, "Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2010, pp.41, 2108~2129
- Chesnut RM, "A trial of intracranial-pressure monitoring in traumatic brain injury", N Engl J Med, 367, pp.2471~2481 (2012)
- Czosnyka M, "Continuous assessment of the cerebral vasomotor reactivity in head injury", Neurosurgery, 41, pp.11~17 (1997)
- Aries MJ, "Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury", Crit Care Med, 40, pp.2456~2463 (2012)
- Poca MA, "Monitoring intracranial pressure in patients with malignant middle cerebral artery infarction: is it useful?", J Neurosurg, 112, pp.648~657 (2010)
- Rose JC, "Continuous monitoring of the microcirculation in neurocritical care: an update on brain tissue oxygenation", Curr Opin Crit Care, 12, pp.97~102 (2006)
- Rosenthal G, "Brain tissue oxygen tension is more indicative of oxygen diffusion than oxygen delivery and metabolism in patients with traumatic brain injury", Crit Care Med, 36, pp.1917~1924 (2008)
- Adams JE, "Oxygen tension of human cerebral grey and white matter. The effect of forced hyperventilation", J Neurosurg, 19, pp.959~963 (1962)
- Menon DK, "Diffusion limited oxygen delivery following head injury", Crit Care Med, 32, pp.1384~1390 (2004)
- Kett-White R, "Adverse cerebral events detected after subarachnoid hemorrhage using brain oxygen and microdialysis probes", Neurosurgery, 50, pp.1213~1221 (2002)
- Bratton SL, "Guidelines for the management of severe traumatic brain injury. X. Brain oxygen monitoring and thresholds", J Neurotrauma, 24, pp.65~70 (2007)
- Steiner T, "Multimodal online monitoring in middle cerebral artery territory stroke", Stroke, 32, pp.2500~2506 (2001)
- Anderson CS, "Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial", Lancet Neurol, 7, pp.391~399 (2008)
- Schell RM, "Cerebral monitoring: jugular venous oximetry", Anesth Analg, 90, pp.559~566 (2000)
- Gupta AK, "Measuring brain tissue oxygenation compared with jugular venous oxygen saturation for monitoring cerebral oxygenation after traumatic brain injury", Anesth Analg, 88, pp.549~553 (1999)
- Kim MN, "Noninvasive measurement of cerebral blood flow and blood oxygenation using near-infrared and diffuse correlation spectroscopies in critically brain-injured adults", Neurocrit Care, 12, pp.173~180 (2010)
- Rosenthal G, "Incorporating a parenchymal thermal diffusion cerebral blood flow probe in bedside assessment of cerebral autoregulation and vasoreactivity in patients with severe traumatic brain injury", J Neurosurg, 114, pp.62~70 (2011)
- Bhatia A, "Neuromonitoring in the intensive care unit. I. Intracranial pressure and cerebral blood flow monitoring", Intensive Care Med, 33, pp.1263~1271 (2007)
- Barazangi N, "Advanced cerebral monitoring in neurocritical care", Neurol India, 56, pp.405~414 (2008)
- Ko SB, "Real time estimation of brain water content in comatose patients", Ann Neurol, 72, pp.344~350 (2012)
- Vajkoczy P, "Regional cerebral blood flow monitoring in the diagnosis of delayed ischemia following aneurysmal subarachnoid hemorrhage", J Neurosurg, 98, pp.1227~1234 (2003)
- Reinstrup P, "Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery", Neurosurgery, 47, pp.701~710 (2000)
- Langemann H, "Extracellular levels of glucose and lactate measured by quantitative microdialysis in the human brain", Neurol Res, 23, pp.531~536 (2001)
- Vespa P, "Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study", J Cereb Blood Flow Metab, 25, pp.763~774 (2005)
- Oddo M, "Induced normothermia attenuates cerebral metabolic distress in patients with aneurysmal subarachnoid hemorrhage and refractory Fever", Stroke, 40, pp.1913~1916 (2009)
- Oddo M, "Impact of tight glycemic control on cerebral glucose metabolism after severe brain injury: a microdialysis study", Crit Care Med, 36, pp.3233~3238 (2008)
- Helbok R, "Systemic glucose and brain energy metabolism after subarachnoid hemorrhage", Neurocrit Care, 12, pp.317~323 (2010)
- Claassen J, "Detection of electrographic seizures with continuous EEG monitoring in critically ill patients", Neurology, 62, pp.1743~1748 (2004)
- De Herdt V, "Early seizures in intracerebral hemorrhage: incidence, associated factors, and outcome", Neurology, 77, pp.1794~1800 (2011)
- Vespa PM, "Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome", Neurology, 60, pp.1441~1446 (2003)
- Waziri A, "Intracortical electroencephalography in acute brain injury", Ann Neurol, 66, pp.366~377 (2009)
- Jordan KG, "Emergency EEG and continuous EEG monitoring in acute ischemic stroke", J Clin Neurophysiol, 21, pp.341~352 (2004)
- van Putten MJ, "Continuous quantitative EEG monitoring in hemispheric stroke patients using the brain symmetry index", Stroke, 35, pp.2489~2492 (2004)
