tailieunhanh - Monitoring of neurocritical care: Part 2

(BQ) Continued part 1, part 2 of the document Monitoring of neurocritical care has contents: Cerebral autoregulation, evoked potentials in neurocritical care, bioinformatics for multimodal monitoring, multimodal monitoring - challenges in implementation and clinical utilization,. and other contents. Invite you to refer. | 7 Cerebral Autoregulation Marek Czosnyka PhD Enrique Carrero Cardenal PhD INTRODUCTION Patients with Drain rnhaies may have impaired cerebral autoregulation. The extent of this impairment may fluctuate with time. A repeatable noninvasive method of monilormg ofautore lvtoay reserve is needed. If autoregnl ation is alleresl. it verrevsns div range of crrnbral perfvskm peesenre CPP him ensurev adequete cvaebrae Wo iag flow ngBIre iisabes omes psseeuee passive. The risk of cerebral hypopeefosion Wchem1 a Q oe hypereinai1 eck Hia. and cerebral eleeBinqieeseaces 3 . Patients tolls eevde larii n ngcry rnpaired cerebra acSHqcSaeen Wes poos outeeme 14 . Sereral inockdiúes see g csantì uaed for lldhllsesv ceaeWfo actoeognsatfo01 Thsy are reviewsd alongwUhccmprehcnaias asccerlnslll sesohnhness oc the segheseel resalts. TRANhC RANIAs DOaPLER uLTRASOhlOGRAPHv Transcramal Doppler LCD ultratonograpPy hahthe ability to continuously assess the autoregulatory reserve. The oa TCD lies encouraged imeieative apClieaaioq is tead-maured patient ansming . íì e ch-narnia and static tests to be evaluated in the clinical setting 5-7 . Static Tess tri Autoregulqrloe Methoys for rhef ifo ii .in of autoregulation rely on observing middle cerebral artery MCA blood flow velocity FV during changes in mean arterial blood pressure ABP indgaedgq an mfusfon ae vavvpsessor llagmIB Tnesta a rase 0s outoregnlns tion SRoR can Ce cekudated ar the peraenlageillcihO e iri vasefoav resWrence dm by the perceniage riin se Ct1 8S B SRoR ea 1100 mdicatoi poraec egnctfonnliirswgareqd a SRoR 0 0 indiastes .ahy .L pIoI1 0 auenrenulation. The Ieslir .clannahy prone ee 85 86 Neurocritical Care Monitoring FIGURE Example of measurement ofSRoR i na TEbl patient. ABPhas beenraised with norepinephrine. Baseline values indsx 1 were compared withvalues recorded after elevation of ABP by 19 mmHg index 2 . SRoRhas been calculated S S5 relutive increase in CVR ceO FH vsHere foV was Hioac aiuen FO ie .