Multimodal monitoring in neurointensive care of severe traumatic brain injury
Authors:
Hejčl Aleš 1; Bolcha Martin 1; Procházka Jan 2; Hušková Eva 3; Sameš Martin 1
Authors place of work:
Neurochirurgická klinika Univerzity Jana Evangelisty Purkyně, Krajská zdravotní, a. s., Masarykova nemocnice, o. z., Ústí nad Labem
1; Centrální JIP, Krajská zdravotní, a. s., Masarykova nemocnice, o. z., Ústí nad Labem
2; Oddělení ARIM, Krajská zdravotní, a. s., Masarykova nemocnice, o. z., Ústí nad Labem
3
Published in the journal:
Anest. intenziv. Med., 21, 2010, č. 2, s. 104-111
Category:
Intensive Care Medicine - Review Article
Summary
The therapy of traumatic brain injury consists of prevention and therapy of secondary injury. Proper and early diagnosis is necessary for adequate treatment. Standard monitoring methods in today’s neurointensive care include clinical observation, intracranial pressure monitoring and repeated brain CT scans. During the last 10 years, new methods have been implemented in clinical practice that can improve our understanding of the pathophysiology of brain injury and provide early diagnosis of secondary trauma. These methods include tissue oxymetry, microdialysis and brain tissue blood flow. Their common application constitutes so called multimodal monitoring. In the following review we introduce these methods in neurointensive care. Further, we summarize our experience with 50 patients with multimodal monitoring since 2006.
Keywords:
head trauma – multimodal monitoring – intracranial pressure – tissue oxymetry – microdialysis – cerebral blood flow
Zdroje
1. Smrčka, M. Poranění mozku. 1. vyd. Praha: Grada Publishing, 2001, 278 s. ISBN 80-7169-820-2.
2. Náhlovský, J. Neurochirurgie. 1. vyd. Praha: Galén, 2006, 581 s. ISBN 80-7262-319-2.
3. Miller, J. D., Becker, D. P., Ward, J. D., Sullivan, H. G., Adams, W. E., Rosner, M. J. Significance of intracranial hypertension in severe head injury. J Neurosurg., 1977, 47, p. 503–516.
4. Monro, A. Observation on the Structure and the Function of the Nervous System. Edinburgh: Creek Johnson, 1783.
5. Kellie, G. An account of the appearance observed in the dissection of two of three individuals presumed to have perished in the storm of the 3D and whose bodies were discovered in the vicinity of Leith on the morning of the 4th November 1821, with some reflections on the pathology of the brain. Trans. Med. Chir. Sci. Edinb., 1824, 1, p. 84.
6. Lundberg, N. Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiat Neurol Scand (Suppl), 1960, 149, p. 1–193.
7. Lozier, A. P., Sciacca, R. R., Romagnoli, M. F., Connolly, E. S. Jr. Ventriculostomy-related infections: a critical review of the literature. Neurosurgery, 2002, 51, p. 170–181.
8. Mayhall, C. G., Archer, N. H., Lamb, V. A., Spadora, A. C., Baggett, J. W., Ward, J. D., Narayan, R. K. Ventriculostomy--related infections. A prospective epidemiologic study. N. Engl. J. Med., 1984, 310, p. 553–559.
9. Lo, C. H., Spelman, D., Bailey, M., Cooper, D. J., Rosenfeld, J. V., Brecknell, J. E. External ventricular drain infections are independent of drain duration: an argument against elective revision. J. Neurosurg., 2007, 106, p. 378–383.
10. Zabramski, J. M., Whiting, D., Darouiche, R. O., Horner, T. G., Olson, J., Robertson, C., Hamilton, A. J. Efficacy of antimicrobial impregnated external ventricular drain catheters: a prospective, randomized, controlled trial. J. Neurosurg., 2003, 98, p. 725–730.
11. Birch, A. A., Eynon, C. A., Schley, D. Erroneous intracranial pressure measurements from simultaneous pressure monitoring and ventricular drainage catheters. Neurocrit. Care, 2006, 5, p. 51–54.
12. The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Intracranial pressure thresholds. J. Neurotrauma, 2007, 24, p. 55–58
13. Narayan, R. K., Kishore, P. R., Becker, D. P., Ward, J. D., Enas, G. G., Greenberg, R. P., Domingues, Da. S. A., Lipper, M. H., Choi, S. C., Mayhall, C. G., Lutz, H. A., III, Young, H. F. Intracranial pressure: tomonitor or not to monitor? A review of our experience with severe head injury. J. Neurosurg., 1982, 56, p. 650–659.
14. Balestreri, M., Czosnyka, M., Hutchinson, P., Steiner, L. A., Hiler, M., Smielewski, P., Pickard, J. D. Impact of intracranial pressure and cerebral perfusion pressure on severe disability and mortalityafter head injury. Neurocrit. Care, 2006, 4, p. 8–13.
15. Saul, T. G., Ducker, T. B. Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury. J. Neurosurg., 1982, 56, p. 498–503.
16. Gibbs, E., Lennox, W., Nims, L. Arterial and cerebral venous blood: arterial-venous differences in man. J. Bio. Chem., 1942, 144, p. 324.
17. Filaun, M., Horáček, M., Steindler, J., Pekař, L., Cvachovec, K. Monitorování mozkové oxygenace. Ces. Slov. Neurol. N., 2008, 71, s. 657–663.
18. Stieffel, M. F., Udoetuk, J. D., Spiotta, A. M., Gracias, V. H., Goldberg, A., Maloney-Wilensky, E., Bloom, S., Le Roux, P. D. Conventional neurocritical care and cerebral oxygenation after traumatic brain injury. J. Neurosurg., 2006, 105, p. 568–575.
19. Gopinath, S. P., Valadka, A. B., Uzura, M., Robertson, C. S. Comparison of jugular venous oxygen saturation and brain tissue PO2 as monitors of cerebral ischemia after head injury. Crit. Care Med., 1999, 27, p. 2337–2345.
20. Johnston, A. J., Steiner, L. A., Coles, J. P., Chatfield, D. A., Fryer, T. D., Smielewski, P., Hutchinson, P. J., O’Connell, M. T., Al-Rawi, P. G., Aigbirihio, F. I., Clark, J. C., Pickard, J. D., Gupta, A. K., Menon, D. K. Effect of cerebral perfusion pressure augmentation on regional oxygenation and metabolism after head injury. Crit. Care Med., 2005, 33, p. 189–195.
21. Kiening, K. L., Härtl, R., Unterberg, A. W., Schneider, G. H., Bardt, T., Lanksch, W. R. Brain tissue pO2-monitoring in comatose patients: implications for therapy. Neurol. Res., 1997, 19, p. 233–240.
22. Jaeger, M., Soehle, M., Meixensberger, J. Brain tissue oxygen (PtiO2): a clinical comparison of two monitoring devices. Acta Neurochir. Suppl., 2005, 95, p. 79–81.
23. Ungerstedt, U., Pycock, C. Functional correlates of dopamine neurotransmission. Bull. Schweiz. Akad. Med. Wiss., 1974, 30, s. 44–55.
24. Martin, G. T., Bowman, H. F. Validation of real-time continuous perfusion measurement. Med. Biol. Eng. Comput., 2000, 38, p. 319–325.
25. Stahl, N., Schalen, W., Ungerstedt, U., Nordstrom, C. H. Bedside biochemical monitoring of the penumbra zone surrounding an evacuated acute subdural haematoma. Acta Neurol. Scand., 2003, 108, p. 211–215.
26. Bellander, B. M., Cantais, E., Enblad, P., Hutchinson, P., Nordström, C. H., Robertson, C., Sahuquillo, J., Smith, M., Stocchetti, N., Ungerstedt, U., Unterberg, A., Olsen, N. V. Consensus meeting on microdialysis in neurointensive care. Intensive Care Med., 2004, 30, p. 2166–2169.
27. Dings, J., Meixensberger, J., Jäger, A., Roosen, K. Clinical experience with 118 brain tissue oxygen partial pressure catheter probes. Neurosurgery, 1998, 43, p. 1082–1095.
28. Tisdall, M. M., Smith, M. Multimodal monitoring in traumatic brain injury: current status and future directions. Br. J. Anaesth., 2007, 99, p. 61–67.
29. Bratton, S. L., Chestnut, R. M., Ghajar, J., McConnell Hammond, F. F., Harris, O. A., Hartl, R., Manley, G. T., Nemecek, A., Newell, D. W., Rosenthal, G., Schouten, J., Shutter, L., Timmons, S. D., Ullman, J. S., Videtta, W., Wilberger, J. E., Wright, D. W. Guidelines for the management of severe traumatic brain injury. X. Brain oxygen monitoring and thresholds. J. Neurotrauma, 2007, 24 Suppl 1, p. 65–70.
30. Meixensberger, J., Jaeger, M., Väth, A., Dings, J., Kunze, E., Roosen, K. Brain tissue oxygen guided treatment supplementing ICP/CPP therapy after traumatic brain injury. J. Neurol. Neurosurg. Psychiatry, 2003, 74, p. 760–764.
31. Belli, A., Sen, J., Petzold, A., Russo, S., Kitchen, N., Smith, M. Metabolic failure precedes intracranial pressure rises in traumatic brain injury: a microdialysis study. Acta Neurochir. (Wien), 2008, 150, p. 461–469.
32. Kett-White, R., Hutchinson, P. J., Al-Rawi, P. G., Gupta, A. K., Pickard, J. D., Kirkpatrick, J. D. Cerebral oxygen and microdialysis monitoring during aneurysma Sumery: effects of blood pressure, cerebrospinal fluid drainage, and temporary clipping on infarction. J. Neurosurg., 2002, 96, p. 1013–1009.
33. Smrčka, M., Ďuriš, K., Juráň, V., Neumann, E., Kýr, M. Peroperační monitoring tkáňové oxymetrie a pooperační užití hypotermie v chirurgii mozkových aneuryzmat. Česk. Slov. Neurol., 2009, 72, p. 245–249.
34. Rabinstein, A. A., Weigand, S., Atkinson, J. L., Wijdicks, E. F. Patterns of cerebral infarction in aneurysmal subarachnoid hemorrhage. Stroke, 2005, 36, p. 992–997.
35. Skjøth-Rasmussen, J., Schulz, M., Kristensen, S. R., Bjerre, P. Delayed neurological deficits detected by an ischemic pattern in the extracellular cerebral metabolites in patients with aneurysmal subarachnoid hemorrhage. J. Neurosurg., 2004, 100, p. 8–15.
36. Unterberg, A. W., Sakowitz, O. W., Sarrafzadeh, A. S., Benndorf, G., Lanksch, W. R. Role of bedside microdialysis in the diagnosis of cerebral vasospasm following aneurysmal subarachnoid hemorrhage. J. Neurosurg., 2001, 94, p. 740–749.
37. Hejčl, A., Bolcha, M., Procházka, J., Sameš, M. Multimodální monitorování mozku u pacientů s těžkým kraniocerebrálním traumatem a subarachnoidálním krvácením v neurointenzivni peči. Česk. Slov. Neurol., 2009, 72, s. 383–387.
38. Reinstrup, P., Ståhl, N., Mellergård, P., Uski, T., Ungerstedt, U., Nordström, C. H. Intracerebral microdialysis in clinical practice: baseline values for chemical markers during wakefulness, anesthesia, and neurosurgery. Neurosurgery, 2000, 47, p. 701–709.
Štítky
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineČlánok vyšiel v časopise
Anaesthesiology and Intensive Care Medicine
2010 Číslo 2
Najčítanejšie v tomto čísle
- The effect of transversus abdominis plane block on post-operative pain relief: a prospective audit
- Multimodal monitoring in neurointensive care of severe traumatic brain injury
- Tomas Kadlic Memorial – Ass. Prof. Tomas Kadlic, M. D.
- Influence of age on the pharmacodynamic parameters of cisatracurium, rocuronium and vecuronium in males during total intravenous anaesthesia – a prospective study