Doing More with Less on Intracranial Pressure Monitoring.
Acute brain injury
Intracranial compliance
Intracranial pressure
Multimodal monitoring
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
09
07
2023
accepted:
12
07
2023
medline:
9
10
2023
pubmed:
24
7
2023
entrez:
23
7
2023
Statut:
ppublish
Résumé
Intracranial pressure (ICP) management based on predetermined thresholds is not accurate in light of recent research on cerebrovascular physiology. Interpersonal and intrapersonal variations will lead ICP elevations to reach individualized thresholds for intracranial compliance impairment from one subject to another. Therefore reuniting the modern techniques of neuromonitoring besides ICP enables practitioners to have a more whole picture in anticipating neuro worsening and improving timing in decision making. Brief literature review. For the severely brain-injured patient, current evidence indicates a personalized and physiology-based multimodal monitoring care to be required rather than decision making according to ICP predetermined cut-offs. The authors' point of view is of particular importance for regions with resource heterogeneity and scarcity, where ICP monitoring is not available for all those in need and noninvasive techniques may provide a surrogate approach. If physicians who deal with acute-brain-injured patients in lower-resource areas understand that several tools besides ICP may improve their practice, it is possible to reduce acute brain injury morbimortality.
Sections du résumé
BACKGROUND
BACKGROUND
Intracranial pressure (ICP) management based on predetermined thresholds is not accurate in light of recent research on cerebrovascular physiology. Interpersonal and intrapersonal variations will lead ICP elevations to reach individualized thresholds for intracranial compliance impairment from one subject to another. Therefore reuniting the modern techniques of neuromonitoring besides ICP enables practitioners to have a more whole picture in anticipating neuro worsening and improving timing in decision making.
METHODS
METHODS
Brief literature review.
RESULTS
RESULTS
For the severely brain-injured patient, current evidence indicates a personalized and physiology-based multimodal monitoring care to be required rather than decision making according to ICP predetermined cut-offs.
CONCLUSIONS
CONCLUSIONS
The authors' point of view is of particular importance for regions with resource heterogeneity and scarcity, where ICP monitoring is not available for all those in need and noninvasive techniques may provide a surrogate approach. If physicians who deal with acute-brain-injured patients in lower-resource areas understand that several tools besides ICP may improve their practice, it is possible to reduce acute brain injury morbimortality.
Identifiants
pubmed: 37482089
pii: S1878-8750(23)00994-4
doi: 10.1016/j.wneu.2023.07.055
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
93-95Informations de copyright
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