Open Access
CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2019; 06(02): 062-071
DOI: 10.1055/s-0039-1692863
Review Article
Indian Society of Neuroanaesthesiology and Critical Care

Multimodal Neuromonitoring: Current Scenario in Neurocritical Care

Keshav Goyal
1   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
,
Ankur Khandelwal
1   Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
,
Shweta Kedia
2   Department of Neurosurgery, Neurosciences Centre, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Publikationsverlauf

Received: 31. März 2019

Accepted after revision: 03. Mai 2019

Publikationsdatum:
19. Juni 2019 (online)

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Abstract

Multimodal neuromonitoring (NM) is the concept of integrating various tools and data to understand brain physiology and guide therapeutic interventions to prevent secondary brain injury. There exists a range of invasive/noninvasive and global/regional monitors of cerebral hemodynamics, oxygenation, metabolism, and electrophysiology that can be used to guide treatment decisions after neurological insult. No single monitoring modality is ideal for all patients. Simultaneous assessment of cerebral hemodynamics, oxygenation, and metabolism allows individualized patient care. The ability to analyze these advanced data for real-time clinical care, however, remains intuitive and primitive. Advanced informatics is promising and may provide us a supportive tool to interpret physiological events and guide pathophysiological-based therapeutic decisions. Available literature is not robust regarding multimodality NM and favorable patient outcome. This narrative review is undertaken to know the status and recent advancement of multimodal NM in neurocritical care.