Multimodality monitoring in neurocritical care.
Multimodality monitoring of cerebral physiology encompasses the application of different monitoring techniques and integration of several measured physiologic and biochemical variables into assessment of brain metabolism, structure, perfusion, and oxygenation status. Novel monitoring techniques include transcranial Doppler ultrasonography, neuroimaging, intracranial pressure, cerebral perfusion, and cerebral blood flow monitors, brain tissue oxygen tension monitoring, microdialysis, evoked potentials, and continuous electroencephalogram. Multimodality monitoring enables immediate detection and prevention of acute neurologic injury as well as appropriate intervention based on patients' individual disease states in the neurocritical care unit. Real-time analysis of cerebral physiologic, metabolic, and cardiovascular parameters simultaneously has broadened knowledge about complex brain pathophysiology and cerebral hemodynamics. Integration of this information allows for more precise diagnosis and optimization of management of patients with brain injury.
Wartenberg
Katja Elfriede
KE
Neurological Intensive Care Unit, New York Presbyterian Hospital, Columbia University Medical Center, 710 W. 168th Street, New York, NY 10032, USA.
Schmidt
J Michael
JM
Mayer
Stephan A
SA
D002493:Central Nervous System Diseases / Q000175:diagnosis*; D054022:Cerebrum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003131:Combined Modality Therapy; D003422:Critical Care / Q000592:standards* / Q000639:trends; D020000:Decision Support Systems, Clinical; D003952:Diagnostic Imaging / Q000639:trends*; D004569:Electroencephalography; D006801:Humans; D007362:Intensive Care Units / Q000592:standards* / Q000639:trends; D008991:Monitoring, Physiologic / Q000379:methods* / Q000639:trends; D009460:Neurologic Examination / Q000379:methods / Q000639:trends; D010092:Oximetry; D014463:Ultrasonography