Neurocritical Care · Neuromonitoring · Traumatic Brain Injury

Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial

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

Acute Cerebrovascular Conditions · EEG · Neuromonitoring · Subarachnoid Haemorrhage

EEG and Oxygenation in Acute Brain Injury

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

Basic Sciences & Physiology · EEG · Neuromonitoring

Introduction to Intraoperative EEG Monitoring – A Starter´s Guide by ICETAP

Ivan came across this very useful and reasonably understandable introduction to EEG monitoring for anaesthetic use. It´s put together by the guys at ICETAP (International Consortium for EEG Training of Anesthesia Practitioners). It´s part of a series of tutorials on all things EEG for complete novices.

Acute Cerebrovascular Conditions · Haemodynamics · Neuromonitoring · Subarachnoid Haemorrhage

Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

Published in 2011 by Schmidt et al (free full-text in Stroke), this article looks at CPP thresholds for cerebral hypoxia in SAH patients. They went through multimodal monitoring data for 30 patients with poor-grade SAH. Using microdialysis and brain tissue oxygenation as their main determinants of hypoxia, they found that patients with a CPP <70… Continue reading Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

Basic Sciences & Physiology · Neuromonitoring

Assessment of cerebral autoregulation patterns with NIRS during pharmacological induced pressure changes

Moerman et al, Anesthesiology Aug 2015. Link to PubMed here. In this study, paradoxical changes in ScO2 after pharmacological-induced pressure changes occurred exclusively in patients with intact cerebral autoregulation, corroborating the hypothesis that these paradoxical responses might be attributable to a functional cerebral autoregulation.