We all recall the elegant curves that ostensibly show the neat relationship between mean arterial blood pressure (or CPP) and cerebral blood flow. This relationship classically has its lower and upper limits, beyond which CBF will vary passively with the systemic pressure. Stay within these limits and all is good, the mantra goes. However, as… Continue reading Cerebral Autoregulation – What do we know?
Okonkwo et al, ten ICUs in the United States. Read their article in Critical Care Medicine, November 2017-issue. They found that management of severe traumatic brain injury informed by multimodal intracranial pressure and brain tissue monitoring reduced brain tissue hypoxia, with a trend toward lower mortality and more favorable outcomes, compared with treatment guided by… Continue reading Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial
A bit more ICP-material for our basic science portfolio: Medscape´s review by Czosnyka and colleagues. It was published in 2007 but remains reasonably current and provides a useful introduction to intracranial pressure monitoring and its derived indices.
I happened upon this review by Wagshul et al, published in 2011. ICP waveforms and the factors influencing them can be difficult to grasp. This article offers an extensive review of the history and science of brain pulsatility. Well worth a read when you have a few spare hours.
This narrative review by Green et al (full text) was published recently in Anaesthesia. It explores the existing literature on the use of near-infrared spectroscopy cerebral oximetry in various settings, including surgery and resuscitation from cardiac arrest.
Excellent review of asssessment of cerebral circulation by Donnelly et al. in Critical Care May 2016. The authors go through most of today’s available modalities and review their utility in neurocritical care. Find the article here.
Really interesting article in the latest issue of JAMA Neurology: Specific EEG changes, known as periodic discharges (PDs), seem to be of value in predicting brain tissue hypoxia in vulnerable patients with acute brain injury. In this investigation, Witsch and colleagues included 90 patients with high-grade subarachnoid haemorrhage and monitored them with continuous EEG in addition to… Continue reading EEG and Oxygenation in Acute Brain Injury