title: The Role of Multimodal Invasive Monitoring in Acute Traumatic Brain Injury.
abstract: This article reviews the role of modalities that directly monitor brain parenchyma in patients with severe traumatic brain injury. The physiology monitored involves compartmental and perfusion pressures, tissue oxygenation and metabolism, quantitative blood flow, pressure autoregulation, and electrophysiology. There are several proposed roles for this multimodality monitoring, such as to track, prevent, and treat the cascade of secondary brain injury; monitor the neurologically injured patient; integrate various data into a composite, patient-specific, and dynamic picture; apply protocolized, pathophysiology-driven intensive care; use as a prognostic marker; and understand pathophysiologic mechanisms involved in secondary brain injury to develop preventive and abortive therapies, and to inform future clinical trials.
authors.affiliation: Division of Neurocritical Care, Department of Neurology, Baylor College of Medicine Medical Center, Baylor College of Medicine, McNair Campus, 7200 Cambridge Street, 9th Floor, MS: NB302, Houston, TX 77030, USA. Electronic address: lazaridi@bcm.edu.
authors.forename: Christos
authors.initials: C
authors.lastname: Lazaridis
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Robertson
mesh_terms: D001921:Brain / Q000503:physiopathology*; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D003422:Critical Care; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008991:Monitoring, Physiologic / Q000379:methods*
keywords: Brain tissue oxygen; Cerebral perfusion pressure; Intracranial pressure; Lactate/pyruvate ratio; Neuromonitoring; Pressure reactivity index