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https://www.readbyqxmd.com/read/28699412/pressure-autoregulation-measurement-techniques-in-adult-tbi-part-ii-a-scoping-review-of-continuous-methods
#1
Frederick Adam Zeiler, Joseph Donnelly, Leanne Calviello, Peter Smieleweski, David Menon, Marek Czosnyka
To perform systematically a scoping review of the literature on commonly described continuous autoregulation measurement techniques in adult TBI. The goal was to provide an overview of methodology and comprehensive reference library of the available literature for each technique. Five separate small systematic reviews were conducted for each of the continuous techniques: pressure reactivity index (PRx), laser Doppler flowmetry (LDF), near infrared spectroscopy (NIRS) techniques, brain tissue oxygen tension (PbtO2), and thermal diffusion (TD) techniques...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28674514/aspects-on-the-physiological-and-biochemical-foundations-of-neurocritical-care
#2
REVIEW
Carl-Henrik Nordström, Lars-Owe Koskinen, Magnus Olivecrona
Neurocritical care (NCC) is a branch of intensive care medicine characterized by specific physiological and biochemical monitoring techniques necessary for identifying cerebral adverse events and for evaluating specific therapies. Information is primarily obtained from physiological variables related to intracranial pressure (ICP) and cerebral blood flow (CBF) and from physiological and biochemical variables related to cerebral energy metabolism. Non-surgical therapies developed for treating increased ICP are based on knowledge regarding transport of water across the intact and injured blood-brain barrier (BBB) and the regulation of CBF...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28665250/prognostic-value-of-changes-in-brain-tissue-oxygen-pressure-before-and-after-decompressive-craniectomy-following-severe-traumatic-brain-injury
#3
Santiago T Lubillo, Dácil M Parrilla, José Blanco, Jesús Morera, Jaime Dominguez, Felipe Belmonte, Patricia López, Ismael Molina, Candelaria Ruiz, Francisco J Clemente, Daniel A Godoy
OBJECTIVE In severe traumatic brain injury (TBI), the effects of decompressive craniectomy (DC) on brain tissue oxygen pressure (PbtO2) and outcome are unclear. The authors aimed to investigate whether changes in PbtO2 after DC could be used as an independent prognostic factor. METHODS The authors conducted a retrospective, observational study at 2 university hospital ICUs. The study included 42 patients who were admitted with isolated moderate or severe TBI and underwent intracranial pressure (ICP) and PbtO2 monitoring before and after DC...
June 30, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28614970/effect-of-cerebrospinal-fluid-drainage-on-brain-tissue-oxygenation-in-traumatic-brain-injury
#4
Omar S Akbik, Mark Krasberg, Edwin M Nemoto, Howard Yonas
The effectiveness of cerebrospinal fluid (CSF) drainage in lowering high intracranial pressure (ICP) is well established in severe traumatic brain injury (TBI). However, recently the use of external ventricular drains and intracranial pressure monitors in traumatic brain injury has come under question. The aim of this retrospective study was to investigate the effect of CSF drainage on brain tissue oxygenation (PbtO2). Using a multimodality monitoring system, we continuously monitored brain tissue oxygenation (PbtO2) and parenchymal ICP during CSF drainage events via a ventriculostomy in 40 patients with severe traumatic brain injury (TBI)...
June 14, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#5
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28338505/effects-of-hypertonic-saline-and-sodium-lactate-on-cortical-cerebral-microcirculation-and-brain-tissue-oxygenation
#6
Vlasta Dostalova, Jitka Schreiberova, Vlasta Dostalova, Jiri Paral, Jaroslav Kraus, Alena Ticha, Vera Radochova, Pavel Dostal
BACKGROUND: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of hypertonic saline (HTS) and sodium lactate (HTL) on cerebral cortical microcirculation and brain tissue oxygenation in a rabbit craniotomy model. METHODS: Rabbits (weight, 1.5 to 2.0 kg) were anesthetized, ventilated mechanically, and subjected to a craniotomy. The animals were allocated randomly to receive a 3...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28171804/hemodynamic-and-neuro-monitoring-for-neurocritically-ill-patients-an-international-survey-of-intensivists
#7
Sanjeev Sivakumar, Fabio S Taccone, Mohammed Rehman, Holly Hinson, Neeraj Naval, Christos Lazaridis
PURPOSE: To investigate multimodality systemic and neuro-monitoring practices in acute brain injury (ABI) and to analyze differences among "neurointensivists" (NI; clinical practice comprised >1/3 by neurocritical care), and other intensivists (OI). METHODS: Anonymous 22-question Web-based survey among physician members of SCCM and ESICM. RESULTS: Six hundred fifty-five responded (66% completion rate); 422 (65%) were OI, and 226 (35%) were NI...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28097330/electroencephalographic-periodic-discharges-and-frequency-dependent-brain-tissue-hypoxia-in-acute-brain-injury
#8
Jens Witsch, Hans-Peter Frey, J Michael Schmidt, Angela Velazquez, Cristina M Falo, Michael Reznik, David Roh, Sachin Agarwal, Soojin Park, E Sander Connolly, Jan Claassen
Importance: Periodic discharges (PDs) that do not meet seizure criteria, also termed the ictal interictal continuum, are pervasive on electroencephalographic (EEG) recordings after acute brain injury. However, their association with brain homeostasis and the need for clinical intervention remain unknown. Objective: To determine whether distinct PD patterns can be identified that, similar to electrographic seizures, cause brain tissue hypoxia, a measure of ongoing brain injury...
March 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/27662529/treatment-of-traumatic-brain-injury-with-17%C3%AE-ethinylestradiol-3-sulfate-in-a-rat-model
#9
Harrison Kim, Tao Yu, Betul Cam-Etoz, Thomas van Groen, William J Hubbard, Irshad H Chaudry
OBJECTIVE 17α-ethynylestradiol-3-sulfate (EE-3-SO4) is a highly water-soluble synthetic estrogen that has an extended half-life (∼ 10 hours) over that of naturally occurring estrogen (∼ 10 minutes). In this study, EE-3-SO4 was evaluated in a lateral fluid percussion-induced traumatic brain injury (TBI) model in rats. METHODS A total of 9 groups of Sprague-Dawley rats underwent craniectomy. Twenty-four hours later, lateral fluid percussion was applied to 6 groups of animals to induce TBI; the remaining 3 groups served as sham control groups...
September 23, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27601907/brain-tissue-partial-pressure-of-oxygen-predicts-the-outcome-of-severe-traumatic-brain-injury-under-mild-hypothermia-treatment
#10
Hongtao Sun, Maohua Zheng, Yanmin Wang, Yunfeng Diao, Wanyong Zhao, Zhengjun Wei
OBJECTIVE: The aim of this study was to investigate the clinical significance and changes of brain tissue partial pressure of oxygen (PbtO2) in the course of mild hypothermia treatment (MHT) for treating severe traumatic brain injury (sTBI). METHODS: There were 68 cases with sTBI undergoing MHT. PbtO2, intracranial pressure (ICP), jugular venous oxygen saturation (SjvO2), and cerebral perfusion pressure (CPP) were continuously monitored, and clinical outcomes were evaluated using the Glasgow Outcome Scale score...
2016: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/27435860/brain-tissue-oxygen-monitoring-and-the-intersection-of-brain-and-lung-a-comprehensive-review
#11
REVIEW
Laura B Ngwenya, John F Burke, Geoffrey T Manley
Traumatic brain injury is a problem that affects millions of Americans yearly and for which there is no definitive treatment that improves outcome. Continuous brain tissue oxygen (PbtO2 ) monitoring is a complement to traditional brain monitoring techniques, such as intracranial pressure and cerebral perfusion pressure. PbtO2 monitoring has not yet become a clinical standard of care, due to several unresolved questions. In this review, we discuss the rationale and technology of PbtO2 monitoring. We review the literature, both historic and current, and show that continuous PbtO2 monitoring is feasible and useful in patient management...
September 2016: Respiratory Care
https://www.readbyqxmd.com/read/27356551/altered-hypermetabolic-response-to-cortical-spreading-depolarizations-after-traumatic-brain-injury-in-rats
#12
Baptiste Balança, Anne Meiller, Laurent Bezin, Jens P Dreier, Stéphane Marinesco, Thomas Lieutaud
Spreading depolarizations are waves of near-complete breakdown of neuronal transmembrane ion gradients, free energy starving, and mass depolarization. Spreading depolarizations in electrically inactive tissue are associated with poor outcome in patients with traumatic brain injury. Here, we studied changes in regional cerebral blood flow and brain oxygen (PbtO2), glucose ([Glc]b), and lactate ([Lac]b) concentrations in rats, using minimally invasive real-time sensors. Rats underwent either spreading depolarizations chemically triggered by KCl in naïve cortex in absence of traumatic brain injury or spontaneous spreading depolarizations in the traumatic penumbra after traumatic brain injury, or a cluster of spreading depolarizations triggered chemically by KCl in a remote window from which spreading depolarizations invaded penumbral tissue...
May 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27290043/a-novel-prognostic-marker-in-severe-traumatic-brain-injury-patients-pbto2-pao2-ratio
#13
R Badenes, A Lozano, F Bilotta, A Cueva, B Ortolá, A Maruenda, J Belda
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27165902/plateau-waves-of-intracranial-pressure-and-partial-pressure-of-cerebral-oxygen
#14
Erhard W Lang, Magdalena Kasprowicz, Peter Smielewski, John Pickard, Marek Czosnyka
This study investigates 55 intracranial pressure (ICP) plateau waves recorded in 20 patients after severe traumatic brain injury (TBI) with a focus on a moving correlation coefficient between mean arterial pressure (ABP) and ICP, called PRx, which serves as a marker of cerebrovascular reactivity, and a moving correlation coefficient between ABP and cerebral partial pressure of oxygen (pbtO2), called ORx, which serves as a marker for cerebral oxygen reactivity. ICP and ICPamplitude increased significantly during the plateau waves, whereas CPP and pbtO2 decreased significantly...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27165893/brain-oxygen-relationship-to-cerebral-perfusion-pressure-depends-on-tip-location-and-time-window-can-brain-o2-be-an-adjunctive-modality-for-determining-optimal-cpp
#15
Soojin Park, Marek Czosnyka, Peter Smielewski
Controversy exists regarding the brain tissue oxygen (PbtO2) monitor's optimal tip location and what it actually measures. Recent work [2] identified a "PbtO2 change point" (CPPbt), below which PbtO2 displays pressure-passive behavior, showing significant correlation with optimal cerebral perfusion pressure (CPPopt) as defined by the pressure reactivity index (PRx). This would further support the concept of CPPopt [1] as an individualized target. We endeavored to validate these findings and further explore the relationship between PbtO2 and suboptimal CPP...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27165868/early-changes-in-brain-oxygen-tension-may-predict-outcome-following-severe-traumatic-brain-injury
#16
J K Rhodes, S Chandrasekaran, P J Andrews
We report on the change in brain oxygen tension (PbtO2) over the first 24 h of monitoring in a series of 25 patients with severe traumatic brain injury (TBI) and relate this to outcome. The trend in PbtO2 for the whole group was to increase with time (mean PbtO2 17.4 [1.75] vs 24.7 [1.60] mmHg, first- vs last-hour data, respectively; p = 0.002). However, a significant increase in PbtO2 occurred in only 17 patients (68 %), all surviving to intensive care unit discharge (p = 0.006). Similarly, a consistent increase in PbtO2 with time occurred in only 13 patients, the correlation coefficient for PbtO2 versus time being ≥0...
2016: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/27095434/brain-multimodality-monitoring-updated-perspectives
#17
REVIEW
David Roh, Soojin Park
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...
June 2016: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/27095125/monitoring-of-brain-oxygenation-during-hypothermic-cpr-a-prospective-porcine-study
#18
Gabriel Putzer, Patrick Braun, Giacomo Strapazzon, Martha Toferer, Miriam Mulino, Bernhard Glodny, Markus Falk, Hermann Brugger, Peter Paal, Raimund Helbok, Peter Mair
BACKGROUND AND AIM: Limited data are available concerning the impact of CPR interventions on cerebral oxygenation during hypothermic cardiac arrest. We therefore studied cerebral perfusion pressure (CPP), brain tissue oxygen tension (PbtO2), cerebral venous oxygen saturation (ScvO2) and regional cerebral oxygen saturation (rSO2) in an animal model of hypothermic CPR. We also assessed the correlation between rSO2 and CPP, PbtO2 and ScvO2 to clarify whether near-infrared spectroscopy (NIRS) may be used to non-invasively monitor changes in cerebral oxygenation during hypothermic CPR...
July 2016: Resuscitation
https://www.readbyqxmd.com/read/26998778/brain-hypoxia-is-exacerbated-in-hypobaria-during-aeromedical-evacuation-in-swine-with-traumatic-brain-injury
#19
Anke H Scultetus, Ashraful Haque, Steve J Chun, Brittany Hazzard, Richard T Mahon, Martin J Harssema, Charles R Auker, Paula Moon-Massat, Debra L Malone, Richard M McCarron
BACKGROUND: There is inadequate information on the physiologic effects of aeromedical evacuation on wounded war fighters with traumatic brain injury (TBI). At altitudes of 8,000 ft, the inspired oxygen is lower than standard sea level values. In troops experiencing TBI, this reduced oxygen may worsen or cause secondary brain injury. We tested the hypothesis that the effects of prolonged aeromedical evacuation on critical neurophysiologic parameters (i.e., brain oxygenation [PbtO2]) of swine with a fluid percussion injury/TBI would be detrimental compared with ground (normobaric) transport...
July 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/26971295/acute-effects-of-intraventricular-nicardipine-on-cerebral-hemodynamics-a-preliminary-finding
#20
Sang-Bae Ko, H Alex Choi, Raimund Helbok, Pedro Kurtz, J Michael Schmidt, Neeraj Badjatia, Jan Claassen, E Sander Connolly, Stephan A Mayer, Kiwon Lee
OBJECTIVE: Intraventricular nicardipine (IVTN) is a treatment option for severe vasospasm in patients with subarachnoid hemorrhage (SAH). However, its acute effects on cerebral hemodynamics have not been studied in detail. METHODS: Between June 2008 and December 2010, IVTN was administered (mainly 4mg every 8h) to 11 SAH patients (54 doses) with multimodality monitoring for refractory vasospasm. Retrospective analyses on physiological parameters were made from baseline and up to 6h after IVTN injection...
May 2016: Clinical Neurology and Neurosurgery
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