Multimodal Monitoring in Neurocritical Care
摘要
Cerebral multimodal monitoring (MMM) offers diverse cerebral monitoring techniques, providing a vital and dynamic evaluation of brain function. It marks a considerable stride in neurocritical care. It enhances the precision of diagnosis, treatment, and prognosis in patients with acute neurological conditions and provides detailed insights into brain function and dynamics. It integrates several monitoring modalities of cerebral hemodynamics, oxygenation, and metabolism. The commonly used techniques include those measuring intracranial pressure (ICP), brain tissue oxygenation (PbtO2), transcranial Doppler (TCD), continuous electroencephalography (cEEG), and near-infrared spectroscopy (NIRS). These techniques can be used individually or combined using an advanced interface. Advancements in multimodality monitoring have paved the way from fixed therapeutic targets toward a patient-specific approach. However, the literature is still evolving regarding therapeutic endpoints to be chased. Therefore, a know-how of the strengths and limitations of each monitoring system is of paramount importance. Implementing various monitoring systems can complicate data interpretation and increase both manpower and costs. Data is still evolving, and a clear benefit of MMM in outcomes remains to be established by robust research.