Multimodal monitoring in the pediatric intensive care unit: new modalities and informatics challenges.
We review several newer modalities to monitor the brain in children with acute neurologic disease in the pediatric intensive care unit, such as partial brain tissue oxygen tension (PbtO2), jugular venous oxygen saturation (SjvO2), near infrared spectroscopy (NIRS), thermal diffusion measurement of cerebral blood flow, cerebral microdialysis, and EEG. We then discuss the informatics challenges to acquire, consolidate, analyze, and display the data. Acquisition includes multiple data types: discrete, waveform, and continuous. Consolidation requires device interoperability and time synchronization. Analysis could include pressure reactivity index and quantitative EEG. Displays should communicate the patient's current status, longitudinal and trend information, and critical alarms.
Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY; Department of Pediatrics, Weill Cornell Medical College, New York, NY; Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY; New York Presbyterian Hospital, New York, NY. Electronic address: zag9005@med.cornell.edu.
Zachary M
ZM
Grinspan
Department of Pediatrics, Weill Cornell Medical College, New York, NY; New York Presbyterian Hospital, New York, NY.
Steven
S
Pon
New York Presbyterian Hospital, New York, NY; Department of Neurologic Surgery, Weill Cornell Medical College, New York, NY.
Jeffrey P
JP
Greenfield
Center for Healthcare Informatics and Policy, Weill Cornell Medical College, New York, NY; New York Presbyterian Hospital, New York, NY; Physician Organization, Weill Cornell Medical College, New York, NY.
Sameer
S
Malhotra
Department of Pediatrics, Weill Cornell Medical College, New York, NY; New York Presbyterian Hospital, New York, NY.
Barry E
BE
Kosofsky
D001921:Brain / Q000503:physiopathology*; D002648:Child; D004569:Electroencephalography; D006801:Humans; D015278:Intensive Care Units, Pediatric; D017551:Microdialysis; D008991:Monitoring, Physiologic / Q000379:methods*; D019265:Spectroscopy, Near-Infrared