Neurointesive Care with Multimodal Monitoring

Abstract

Head injury is a major cause of disability and death among young people. Neurointensive care has reduced the mortality and improved the outcome after severe traumatic brain over recent decades. The development of neuromonitoring in neurointensive care units has enabled early detection of secondary complications and, thereby reduce secondary brain damage. Neurointensive care units have made advances with continuous neuromonitoring during the past decade. Improvements in neurointensive care have been predominantly in intensification and optimization of already established ways to monitor and treat patients. Primary brain damage is damage sustained immediately on direct impact. Secondary brain damage often results several days after from a secondary brain insult. Modern neurointensive care focus has been on prevention of secondary brain damage. Intracranially, as secondary brain damage advances, we see a rise in intracranial pressure, increased edema, vasospasm and seizure activity. Systemic manifestations of secondary brain damage are anoxia, hypercapnia, hypocapnia, hypotension, hyperthermia and hyperglycemia. In our study we collected the intracranial and systemic clinical effects of brain damage by using our NICU’s advanced monitoring systems. By using this continuous neurointensive monitoring our institution’s goal is to ultimately prevent and to establish effective treatment strategies for secondary brain insult.