title: Recommendations for the use of multimodal monitoring in the neurointensive care unit.
abstract: OBJECTIVE
  Multimodal monitoring (MMM) is routinely applied in neurointensive care. Unfortunately, there is no robust evidence on which MMM-derived physiologic variables are the most clinically relevant, how and when they should be monitored, and whether MMM impacts outcome. The complexity is even higher because once the data are continuously collected, interpretation and integration of these complex physiologic events into targeted individualized care is still embryonic.
  
  
  RESULTS
  Recent clinical investigation mainly focused on intracranial pressure, perfusion of the brain, and oxygen availability along with electrophysiology. Moreover, a series of articles reviewing the available evidence on all the MMM tools, giving practical recommendations for bedside MMM, has been published, along with other consensus documents on the role of neuromonitoring and electroencephalography in this setting.
  
  
  CONCLUSIONS
  MMM allows comprehensive exploration of the complex pathophysiology of acute brain damage and, depending on the different configuration of the pathological condition we are treating, the application of targeted individualized care. Unfortunately, we still lack robust evidence on how to better integrate MMM-derived information at the bedside to improve patient management. Advanced informatics is promising and may provide us a supportive tool to interpret physiologic events and guide pathophysiological-based therapeutic decisions.
authors.affiliation: aDepartment of Health Science, University of Milan-Bicocca, Monza bNeurointensive Care, Department of Emergency and Intensive Care, San Gerardo Hospital, Monza, Italy cDepartment of Intensive Care Medicine, Faculty of Biology and Medicine, CHUV-Lausanne University Hospital, Lausanne, Switzerland dDepartment of Intensive Care, Hopital Erasme Université Libre de Bruxelles, Bruxelles, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Citerio
authors.forename: Mauro
authors.initials: M
authors.lastname: Oddo
authors.forename: Fabio Silvio
authors.initials: FS
authors.lastname: Taccone
mesh_terms: D001921:Brain / Q000503:physiopathology; D001930:Brain Injuries / Q000503:physiopathology* / Q000628:therapy; D002560:Cerebrovascular Circulation / Q000502:physiology; D004569:Electroencephalography / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D007427:Intracranial Pressure / Q000502:physiology; D017551:Microdialysis / Q000379:methods; D008991:Monitoring, Physiologic / Q000379:methods*; D010101:Oxygen Consumption / Q000502:physiology; D017410:Practice Guidelines as Topic