Early-Goal Directed Therapy for Brain-Injured Patients

被引:1
作者
Brasil, Sergio [1 ]
Salvagno, Michele [2 ]
Baggiani, Marta [3 ]
Taccone, Fabio Silvio [2 ]
机构
[1] Univ Sao Paulo, Dept Neurol, Div Neurosurg, Sch Med, Sao Paulo, Brazil
[2] Univ Libre Bruxelles ULB, Hop Univ Bruxelles HUB, Dept Intens Care, Route Lennik 808, B-1070 Brussels, Belgium
[3] Univ Milano Bicocca, San Gerardo Hosp, Sch Med & Surg, Neurointens Care, Monza, Italy
关键词
Acute brain injuries; Early goal-directed therapy; Neuromonitoring; Secondary brain injuries; Neuro-intensive care unit; Neurocritical care; Therapeutic interventions; CEREBRAL PERFUSION-PRESSURE; INTRACRANIAL-PRESSURE; INTENSIVE-CARE; HEMODYNAMIC MANAGEMENT; CONSENSUS CONFERENCE; HEAD-INJURY; OXYGEN; OPTIMIZATION; THRESHOLDS; GUIDELINES;
D O I
10.1007/s40140-024-00615-2
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of ReviewAcute brain injury, whether resulting from trauma, ischemia, or other causes, presents a significant challenge in critical care medicine. The brain's vulnerability necessitates a proactive approach to minimize secondary brain injuries that can have profound consequences. Multimodal monitoring of systemic and cerebral variables complements these efforts by providing continuous, objective data on brain physiology and pathophysiology, enabling timely interventions.Recent FindingsRecent advancements have shown that integrating neuromonitoring with systemic variables allows for individualized care, minimizing secondary insults and promoting neuroprotection. This approach helps in minimizing secondary insults to the brain and promotes neuroprotection. However, challenges include the lack of standardized protocols for interpreting neuromonitoring data, potential variability in clinical decision-making, and the need for specialized expertise. Despite these advancements, there is limited data on protocolized care based on neuromonitoring values.SummaryThis review aims to summarize existing evidence on the role of goal-directed therapy in managing brain-injured patients. It has been highlighted the importance of multimodal neuromonitoring in enhancing patient outcomes and the need for further research and standardization in this area to improve the care of patients with acute brain injuries.
引用
收藏
页码:187 / 196
页数:10
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