Neurológia pre prax 2/2013

Craniocerebral injury news in acute care

In a synoptic work are described possibilities of current acute care of craniocerebral injury with emphasis on neuromonitoring. In the first part there is mentioned monitoring of basic system parameters such as ECG, pulse oximetry, blood pressure, body temperature, laboratory monitoring, central venous pressure and fluid balance in a view of the potential negative impact of their pathological values in brain tissue. The second part describes in more details the possibilities of cerebral monitoring with global monitoring parameters such as measurement of intracranial pressure and cerebral perfusion pressure measurement and local monitoring parameters, which include monitoring of tissue oximetry, near-infrared spectroscopy, monitoring of cerebral blood flow and brain microdialysis. There is also described the methodology implementation and interpretation of some monitoring values. CT monitoring and evaluation of neurological status is also mentioned. Without the ability of neuromonitoring the care is not possible for severe craniocerebral injuries and for it‘s economic sophistication belongs only to fully equipped trauma centers.

Keywords: neuromonitoring, brain injury, cerebral perfusion pressure, tissue oximetry, near-infrared spectroscopy.