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Review
. 2019 Nov 26:10:1261.
doi: 10.3389/fneur.2019.01261. eCollection 2019.

Approaches to Multimodality Monitoring in Pediatric Traumatic Brain Injury

Brian Appavu  1   2 , Brian T Burrows  1 , Stephen Foldes  1   2 , P David Adelson  1   2
Affiliations
Review

Approaches to Multimodality Monitoring in Pediatric Traumatic Brain Injury

Brian Appavu et al. Front Neurol. .

Abstract

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children. Improved methods of monitoring real-time cerebral physiology are needed to better understand when secondary brain injury develops and what treatment strategies may alleviate or prevent such injury. In this review, we discuss emerging technologies that exist to better understand intracranial pressure (ICP), cerebral blood flow, metabolism, oxygenation and electrical activity. We also discuss approaches to integrating these data as part of a multimodality monitoring strategy to improve patient care.

Keywords: autoregulation; multimodality monitoring; neurocritical care; pediatrics; traumatic brain injury.

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Figures

Figure 1
Figure 1
Optimal cerebral perfusion pressure based upon model-based indices of cerebral autoregulation. Multimodal monitoring data is recorded from a 3-year-old boy with severe TBI. Here, an optimal cerebral perfusion pressure (CPPopt) is estimated using three model-based indices of cerebral autoregulation, including the pressure reactivity index (PRx), oxygen-reactivity index (ORx), and cerebral oximetry index. U-shaped curves can be observed using all three indices, with CPPOpt ranging from 66 to 71 mmHg.
See this image and copyright information in PMC

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