The critical care management of patients who have suffered catastrophic neurological injuries such as intracerebral hemorrhage, traumatic brain injury, ischemic stroke and subarachnoid hemorrhage has undergone significant advances in the last few decades. The intensivist caring for these patients now has a full armamentarium of invasive and noninvasive monitoring techniques for gathering real-time information regarding the physiology and metabolism of the injured brain in patients who are comatose, rendering the neurological examination unreliable or incomplete. The monitoring techniques available today in the ICU allow for measurement of intracranial pressure (ICP), cerebral perfusion pressure (CPP), cerebral blood flow (CBF), oxygenation, temperature, cerebral cellular metabolism, and, most recently, intracortical electroencephalography. The data yielded from intracranial monitoring in this subset of critically ill patients provides information down to the cellular level, helping to guide management and improve outcomes.1,2
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.
Spain D, McIlvoy L, Fix S, et al. Effect of clinical pathway for severe traumatic brain injury on resource utilization. J Trauma. 1998;45(1):101–105.PubMedCrossRefGoogle Scholar
Simons R, Eliopoulos V, Laflamme D, Brown D. Impact on process of trauma care delivery 1 year after introduction of trauma program in a provincial trauma center. J Trauma. 1999;46(5):811–816.PubMedCrossRefGoogle Scholar
Davis JW, Davis IC, Bennink LD, et al. Placement of Intracranial Pressure Monitors: Are “Normal” Coagulation Parameters Necessary? J Trauma. 2004;57(6):1173–1177.PubMedCrossRefGoogle Scholar
American Society of Anesthesiologists Task Force on Blood Component Therapy. Practice guidelines for blood component therapy. Anesthesiology. 1996;84:732–747.CrossRefGoogle Scholar
Office of Medical Applications of Research, National Institutes of Health. Fresh frozen plasma: indications and risks. JAMA. 1985;253:551–553.CrossRefGoogle Scholar
College of American Pathologists. Practice parameters for the use of fresh-frozen plasma, cryoprecipitate and platelets. JAMA. 1994;271:777–781.CrossRefGoogle Scholar
Stoikes NF, Magnotti LJ, Hodges TM, et al. Impact of intracranial pressure monitor prophylaxis on central nervous system infections and bacterial multi-drug resistance. Surg Infect. 2008;9(5):503–508.CrossRefGoogle Scholar
Carter LP, Weinand ME, Oommen KJ. Cerebral blood flow (CBF) in intensive care by thermal diffusion. Acta Neurochir Suppl (Wien). 1993;59:43–46.Google Scholar
De Georgia MA, Deoaonkar A. Multimodal monitoring in the neurological intensive care unit. Neurologist. 2005;11(1):45–52.PubMedCrossRefGoogle Scholar