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2014 ; 54
(11
): 870-7
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Update on intensive neuromonitoring for patients with traumatic brain injury: a
review of the literature and the current situation
#MMPMID25367587
Koizumi H
; Suehiro E
; Fujiyama Y
; Sugimoto K
; Inoue T
; Suzuki M
Neurol Med Chir (Tokyo)
2014[]; 54
(11
): 870-7
PMID25367587
show ga
Intracranial pressure (ICP) measurements are fundamental in the present protocols
for intensive care of patients during the acute stage of severe traumatic brain
injury. However, the latest report of a large scale randomized clinical trial
indicated no association of ICP monitoring with any significant improvement in
neurological outcome in severely head injured patients. Aggressive treatment of
patients with therapeutic hypothermia during the acute stage of traumatic brain
injury also failed to show any significant beneficial effects on clinical
outcome. This lack of significant results in clinical trials has limited the
therapeutic strategies available for treatment of severe traumatic brain injury.
However, combined application of different types of neuromonitoring, including
ICP measurement, may have potential benefits for understanding the
pathophysiology of damaged brains. The combination of monitoring techniques is
expected to increase the precision of the data and aid in prevention of secondary
brain damage, as well as assist in determining appropriate time periods for
therapeutic interventions. In this study, we have characterized the techniques
used to monitor patients during the acute severe traumatic brain injury stage, in
order to establish the beneficial effects on outcome observed in clinical studies
conducted in the past and to follow up any valuable clues that point to
additional strategies for aggressive management of these patients.
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