Cerebral Monitoring May Aid Assessment of Brain Function During Cardiac Arrest

The overall aims of neuromonitoring are to identify worsening neurological function and secondary cerebral insults that may benefit from specific treatment(s) and improve pathophysiological understanding of cerebral disease in critical illness, to provide clear physiological data to guide and individualize therapy, as well as assist with neuroprognostication. It’s not a novel concept to directly monitor the organ of interest to direct and assess therapies. The human brain constitutes 2% of the total body weight, yet the energy-consuming processes that enable the brain to function adequately account for about 25% of total body energy expenditure and 20% oxygen consumption of the whole organism. Noninvasive evaluation of cerebral blood flow (CBF) is possible with transcranial Doppler (TCD), utilizing derived pulsatility index or optic nerve sonography. However, methods for continuous online monitoring of the brain remains primarily invasive. Intraventricular devices have long been considered the gold standard for measurement of cerebral oxygenation; intraparenchymal devices are particularly useful when intracranial pressure monitoring and drainage is also desirable. Though noninvasive monitoring of cerebral oxygenation exists, there’s little evidence for its usefulness outside of the operating room. Continuous measurement of CBF is now feasible using a thermal diffusion probe (TDP), which shows good correlation with CBF as measured by xenon-CT. TCD shows flow velocity rathe...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Cardiac & Resuscitation Top Story Exclusive Articles Patient Care Heart of America Source Type: news