Monitoring of Cerebral Blood Flow and Ischemia in the Critically Ill

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

doi:10.1007/s12028-014-0021-9

Monitoring of Cerebral Blood Flow and Ischemia in the Critically Ill

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Secondary ischemic injury is common after acute brain injury and can be evaluated with the use of neuromonitoring devices. This manuscript provides guidelines for the use of devices to monitor cerebral blood flow (CBF) in critically ill patients. A Medline search was conducted to address essential pre-specified questions related to the utility of CBF monitoring. Peer-reviewed recommendations were constructed according to the GRADE criteria based upon the available supporting literature. Transcranial Doppler ultrasonography (TCD) and transcranial color-coded duplex sonography (TCCS) are predictive of angiographic vasospasm and delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage. TCD and TCCS may be beneficial in identifying vasospasm after traumatic brain injury. TCD and TCCS have shortcomings in identifying some secondary ischemic risks. Implantable thermal diffusion flowmetry (TDF) probes may provide real-time continuous quantitative assessment of ischemic risks. Data are lacking regarding ischemic thresholds for TDF or their correlation with ischemic injury and clinical outcomes.TCD and TCCS can be used to monitor CBF in the neurocritical care unit. Better and more developed methods of continuous CBF monitoring are needed to limit secondary ischemic injury in the neurocritical care unit.

Original language	English (US)
Pages (from-to)	121-128
Number of pages	8
Journal	Neurocritical Care
Volume	21
Issue number	2
DOIs	https://doi.org/10.1007/s12028-014-0021-9
State	Published - Oct 1 2014

Keywords

Cerebral blood flow
Ischemia
Multimodality monitoring
Neurocritical care
Thermal diffusion flowmetry
Transcranial Doppler

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine
Clinical Neurology

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10.1007/s12028-014-0021-9

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title = "Monitoring of Cerebral Blood Flow and Ischemia in the Critically Ill",

abstract = "Secondary ischemic injury is common after acute brain injury and can be evaluated with the use of neuromonitoring devices. This manuscript provides guidelines for the use of devices to monitor cerebral blood flow (CBF) in critically ill patients. A Medline search was conducted to address essential pre-specified questions related to the utility of CBF monitoring. Peer-reviewed recommendations were constructed according to the GRADE criteria based upon the available supporting literature. Transcranial Doppler ultrasonography (TCD) and transcranial color-coded duplex sonography (TCCS) are predictive of angiographic vasospasm and delayed ischemic neurological deficits after aneurysmal subarachnoid hemorrhage. TCD and TCCS may be beneficial in identifying vasospasm after traumatic brain injury. TCD and TCCS have shortcomings in identifying some secondary ischemic risks. Implantable thermal diffusion flowmetry (TDF) probes may provide real-time continuous quantitative assessment of ischemic risks. Data are lacking regarding ischemic thresholds for TDF or their correlation with ischemic injury and clinical outcomes.TCD and TCCS can be used to monitor CBF in the neurocritical care unit. Better and more developed methods of continuous CBF monitoring are needed to limit secondary ischemic injury in the neurocritical care unit.",

keywords = "Cerebral blood flow, Ischemia, Multimodality monitoring, Neurocritical care, Thermal diffusion flowmetry, Transcranial Doppler",

author = "{The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring} and Chad Miller and Rocco Armonda and {Le Roux}, Peter and Menon, {David K.} and Paul Vespa and Giuseppe Citerio and Bader, {Mary Kay} and Brophy, {Gretchen M.} and Diringer, {Michael N.} and Nino Stocchetti and Walter Videtta and Neeraj Badjatia and Julian Boesel and Randal Chesnut and Sherry Chou and Jan Claassen and Marek Czosnyka and {De Georgia}, Michael and Anthony Figaji and Jennifer Fugate and Raimund Helbok and David Horowitz and Peter Hutchinson and Monisha Kumar and Molly McNett and Andrew Naidech and Mauro Oddo and Olson, {Dai Wai} and Kristine O{\textquoteright}Phelan and Javier Provencio and Corina Puppo and Richard Riker and Claudia Robertson and Schmidt, {J. Michael} and Fabio Taccone",

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AU - Le Roux, Peter

AU - Menon, David K.

AU - Vespa, Paul

AU - Citerio, Giuseppe

AU - Bader, Mary Kay

AU - Brophy, Gretchen M.

AU - Diringer, Michael N.

AU - Stocchetti, Nino

AU - Videtta, Walter

AU - Badjatia, Neeraj

AU - Boesel, Julian

AU - Chesnut, Randal

AU - Chou, Sherry

AU - Claassen, Jan

AU - Czosnyka, Marek

AU - De Georgia, Michael

AU - Figaji, Anthony

AU - Fugate, Jennifer

AU - Helbok, Raimund

AU - Horowitz, David

AU - Hutchinson, Peter

AU - Kumar, Monisha

AU - McNett, Molly

AU - Naidech, Andrew

AU - Oddo, Mauro

AU - Olson, Dai Wai

AU - O’Phelan, Kristine

AU - Provencio, Javier

AU - Puppo, Corina

AU - Riker, Richard

AU - Robertson, Claudia

AU - Schmidt, J. Michael

AU - Taccone, Fabio

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KW - Ischemia

KW - Multimodality monitoring

KW - Neurocritical care

KW - Thermal diffusion flowmetry

KW - Transcranial Doppler

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Monitoring of Cerebral Blood Flow and Ischemia in the Critically Ill

Abstract

Keywords

ASJC Scopus subject areas

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