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Brain Multimodality Monitoring: Updated Perspectives

  • Critical Care (SA Mayer, Section Editor)
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Abstract

The challenges posed by acute brain injury (ABI) involve the management of the initial insult in addition to downstream inflammation, edema, and ischemia that can result in secondary brain injury (SBI). SBI is often subclinical, but can be detected through physiologic changes. These changes serve as a surrogate for tissue injury/cell death and are captured by parameters measured by various monitors that measure intracranial pressure (ICP), cerebral blood flow (CBF), brain tissue oxygenation (PbtO2), cerebral metabolism, and electrocortical activity. In the ideal setting, multimodality monitoring (MMM) integrates these neurological monitoring parameters with traditional hemodynamic monitoring and the physical exam, presenting the information needed to clinicians who can intervene before irreversible damage occurs. There are now consensus guidelines on the utilization of MMM, and there continue to be new advances and questions regarding its use. In this review, we examine these recommendations, recent evidence for MMM, and future directions for MMM.

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  1. Department of Neurology and Neurocritical Care, Columbia University, 177 Fort Washington Ave, New York, NY, 10032, USA

    David Roh & Soojin Park

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  1. David Roh
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David Roh declares that he has no conflict of interest.

Soojin Park reports grants from National Institutes of Health K01-ES026833.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Authors’ Contributions

Roh: Acquisition of data, analysis and interpretation, draft of the manuscript, and critical revision of the manuscript for important intellectual content.

Park: Critical revision of the manuscript for important intellectual content.

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SP is supported by the National Institute of Environmental Health Sciences of the National Institutes of Health under Award Number K01ES026833. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Roh, D., Park, S. Brain Multimodality Monitoring: Updated Perspectives. Curr Neurol Neurosci Rep 16, 56 (2016). https://doi.org/10.1007/s11910-016-0659-0

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