The intracranial compartmental syndrome: a proposed model for acute brain injury monitoring and management

Critical Care, Год журнала: 2023, Номер 27(1)

Опубликована: Апрель 10, 2023

Abstract For decades, one of the main targets in management severe acute brain injury (ABI) has been intracranial hypertension (IH) control. However, determination IH suffered variations its thresholds over time without clear evidence for it. Meanwhile, progress understanding content (brain, blood and cerebrospinal fluid) dynamics recent development monitoring techniques suggest that targeting compliance (ICC) could be a more reliable approach rather than guiding actions by predetermined pressure values. It is known ICC impairment forecasts IH, as volume may rapidly increase inside skull, closed bony box with derisory expansibility. Therefore, an compartmental syndrome (ICCS) can occur deleterious effects, precipitating reduction perfusion, thereby inducing ischemia. The present perspective review aims to discuss ICCS concept integrative model combination modern invasive noninvasive assessment. theory logic multiple ancillary methods enhance prediction, pointing proactive improving patient outcomes.

Язык: Английский

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Non-Invasive Intracranial Pressure Monitoring

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(6), С. 2209 - 2209

Опубликована: Март 13, 2023

(1) Background: Intracranial pressure (ICP) monitoring plays a key role in the treatment of patients intensive care units, as well during long-term surgeries and interventions. The gold standard is invasive measurement via ventricular drainage or parenchymal probe. In recent decades, numerous methods for non-invasive have been evaluated but none become established routine clinical practice. aim this study was to reflect on current state research shed light relevant techniques future application. (2) Methods: We performed PubMed search “non-invasive AND ICP (measurement OR monitoring)” identified 306 results. On basis these results, we conducted an in-depth source analysis identify additional methods. Studies were analyzed design, patient type (e.g., infants, adults, shunt patients), statistical evaluation (correlation, accuracy, reliability), number included measurements, assessment accuracy reliability. (3) Results: MRI-ICP two-depth Doppler showed most potential (and complex methods). Tympanic membrane temperature, diffuse correlation spectroscopy, natural resonance frequency, retinal vein approaches also promising. (4) Conclusions: To date, no convincing evidence supports use particular method intracranial measurement. However, many new are under development.

Язык: Английский

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Evolving concepts in intracranial pressure monitoring - from traditional monitoring to precision medicine

Neurotherapeutics, Год журнала: 2025, Номер unknown, С. e00507 - e00507

Опубликована: Янв. 1, 2025

Язык: Английский

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A Point-of-Care Noninvasive Technique for Surrogate ICP Waveforms Application in Neurocritical Care

Neurocritical Care, Год журнала: 2023, Номер 40(1), С. 170 - 176

Опубликована: Июль 12, 2023

Язык: Английский

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An ultrasensitive multimodal intracranial pressure biotelemetric system enabled by exceptional point and iontronics

Nature Communications, Год журнала: 2024, Номер 15(1)

Опубликована: Ноя. 5, 2024

The accurate monitoring of vital physiological parameters, exemplified by heart rate, respiratory and intracranial pressure (ICP), is paramount importance, particularly for managing severe cranial injuries. Despite the rapid development implantable ICP sensing systems over past decades, they still suffer from, example, wire connection, low sensitivity, poor resolution, inability to monitor multiple variables simultaneously. Here, we propose an ultrasensitive multimodal biotelemetric system that amalgamates iontronic transducer with exceptional point (EP) operation signals. proposed can exhibit extraordinary performance regarding detection minuscule fluctuation, demonstrated sensitivity 115.95 kHz/mmHg resolution down 0.003 mmHg. Our excels not only in quantification levels but also distinguishing respiration cardiac activities from signals, thereby achieving ICP, respiratory, rates within a single system. work may provide pragmatic avenue real-time wireless thus hold great potential be extended other indicators. parameters importance. authors rate.

Язык: Английский

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Machine learning approach for noninvasive intracranial pressure estimation using pulsatile cranial expansion waveforms

npj Digital Medicine, Год журнала: 2025, Номер 8(1)

Опубликована: Янв. 26, 2025

Abstract Noninvasive methods for intracranial pressure (ICP) monitoring have emerged, but none has successfully replaced invasive techniques. This observational study developed and tested a machine learning (ML) model to estimate ICP using waveforms from cranial extensometer device (brain4care [B4C] System). The explored multiple waveform parameters optimize mean estimation. Data 112 neurocritical patients with acute brain injuries were used, 92 randomly assigned training testing, 20 reserved independent validation. ML achieved absolute error of 3.00 mmHg, 95% confidence interval within ±7.5 mmHg. Approximately 72% estimates the validation sample 0-4 mmHg values. proof-of-concept demonstrates that noninvasive estimation via B4C System is feasible. Prospective studies are needed validate model’s clinical utility across diverse settings.

Язык: Английский

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Validation of a Noninvasive Approach for Cerebrospinal Compliance Monitoring

Neurocritical Care, Год журнала: 2025, Номер unknown

Опубликована: Фев. 7, 2025

Язык: Английский

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Towards quantitative assessment of cerebrovascular autoregulation in human neonates using ultrafast ultrasound imaging

Scientific Reports, Год журнала: 2025, Номер 15(1)

Опубликована: Апрель 11, 2025

Abstract Newborns with congenital heart diseases requiring cardiopulmonary bypass (CPB) are at risk of neurodevelopmental impairment. The impact deep hypothermia (DH-CPB) on cerebrovascular autoregulation (CAR) that controls brain perfusion in the presence blood pressure variation is not well understood. Recently, ultrafast power Doppler (UPD) showed potential to study CAR neonates based cerebral volume (CBV). However, since relies mainly arterial vasoconstriction/vasodilation, monitoring CBV requires discrimination from venous CBV. This aims use UPD combined an algorithm for arteries and veins monitor during DH-CPB neonates. Transfontanellar was performed two groups newborns: those undergoing hypothermic circulatory arrest (18–20 °C, n = 6, “DH group”) full-flow CPB mild (32–34 “non-DH group”). Blood flow directionality used differentiate compartments specific regions where flows exhibit opposite directions. To CAR, a linear mixed effect model find association between mean (MAP). In group”, we found negative MAP, indicating increase MAP associated decrease (slope -0.020 $$\:{mmHg}^{-1}$$ , p 0.047). Conversely, group” no significant such remained stable as increased ( 0.314). We interpret reduction increasing active vasoconstriction triggered by whereas lack DH group suggests impaired response. Our findings highlight ultrasound imaging intra-operative monitoring, paving way better understanding different types perfusion.

Язык: Английский

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Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension

Neurocritical Care, Год журнала: 2025, Номер unknown

Опубликована: Апрель 28, 2025

Язык: Английский

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Noninvasive Method Using Mechanical Extensometer for the Estimation of Intracranial Compliance by Repeated Measures Agreement Analysis

Neurocritical Care, Год журнала: 2024, Номер unknown

Опубликована: Сен. 18, 2024

Язык: Английский

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