Advanced Monitoring of Systemic Hemodynamics in Critically Ill Patients with Acute Brain Injury

The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Hemodynamic monitoring is widely used in critical care; however, the impact of such intervention in patients with acute brain injury (ABI) remains unclear. Using PubMed, a systematic review was performed (1966–August 2013), and 118 studies were included. Data were extracted using the PICO approach. The evidence was classified, and recommendations were developed according to the GRADE system. Electrocardiography and invasive monitoring of arterial blood pressure should be the minimal hemodynamic monitoring required in unstable or at-risk patients in the intensive care unit. Advanced hemodynamic monitoring (i.e., assessment of preload, afterload, cardiac output, and global systemic perfusion) could help establish goals that take into account cerebral blood flow and oxygenation, which vary depending on diagnosis and disease stage. Choice of techniques for assessing preload, afterload, cardiac output, and global systemic perfusion should be guided by specific evidence and local expertise. Hemodynamic monitoring is important and has specific indications among ABI patients. Further data are necessary to understand its potential for therapeutic interventions and prognostication.

Original languageEnglish (US)
Pages (from-to)38-63
Number of pages26
JournalNeurocritical Care
Volume21
Issue number2
DOIs
StatePublished - Oct 1 2014

Keywords

  • Brain injury
  • Cardiac function
  • Consensus
  • Critical care
  • Hemodynamic
  • Monitoring
  • Outcome
  • Prognosis
  • Recommendations

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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    The Participants in the International Multidisciplinary Consensus Conference on Multimodality Monitoring (2014). Advanced Monitoring of Systemic Hemodynamics in Critically Ill Patients with Acute Brain Injury. Neurocritical Care, 21(2), 38-63. https://doi.org/10.1007/s12028-014-0033-5