| Traumatic brain injury: advanced multimodal neuromonitoring from theory to clinical practice. | |
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MedLine Citation:
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PMID: 20592189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Traumatic brain injury accounts for nearly 1.4 million injuries and 52 000 deaths annually in the United States. Intensive bedside neuromonitoring is critical in preventing secondary ischemic and hypoxic injury common to patients with traumatic brain injury in the days following trauma. Advancements in multimodal neuromonitoring have allowed the evaluation of changes in markers of brain metabolism (eg, glucose, lactate, pyruvate, and glycerol) and other physiological parameters such as intracranial pressure, cerebral perfusion pressure, cerebral blood flow, partial pressure of oxygen in brain tissue, blood pressure, and brain temperature. This article highlights the use of multimodal monitoring in the intensive care unit at a level I trauma center in the Pacific Northwest. The trends in and significance of metabolic, physiological, and hemodynamic factors in traumatic brain injury are reviewed, the technical aspects of the specific equipment used to monitor these parameters are described, and how multimodal monitoring may guide therapy is demonstrated. As a clinical practice, multimodal neuromonitoring shows great promise in improving bedside therapy in patients with traumatic brain injury, ultimately leading to improved neurological outcomes. |
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Authors:
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Sandy Cecil; Patrick M Chen; Sarah E Callaway; Susan M Rowland; David E Adler; Jefferson W Chen |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-06-30 |
Journal Detail:
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Title: Critical care nurse Volume: 31 ISSN: 1940-8250 ISO Abbreviation: Crit Care Nurse Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-04-04 Completed Date: 2011-08-19 Revised Date: 2011-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8207799 Medline TA: Crit Care Nurse Country: United States |
Other Details:
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Languages: eng Pagination: 25-36; quiz 37 Citation Subset: N |
Affiliation:
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Legacy Emanuel Medical Center in Portland, Oregon, USA. scecil@lhs.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anoxia
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prevention & control Biological Markers / metabolism Brain Injuries / epidemiology, metabolism, nursing*, physiopathology, therapy Education, Nursing, Continuing* Humans Intensive Care* / methods Intensive Care Units Ischemia / prevention & control Microdialysis Monitoring, Physiologic / nursing* Northwestern United States / epidemiology Patient Care Management Trauma Centers Trauma Severity Indices Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
| Comments/Corrections | |
Comment In:
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Crit Care Nurse. 2011 Aug;31(4):18-9; author's reply 19
[PMID:
21807677
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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