우리는 그들의 작품에 대 한 NICU에서 모든 동료를 인정 하 고 싶습니다.

이 프로토콜 제도적 검토 보드의 이시바시 병원, 상하이 교통 대학의과 대학에 의해 승인 되었다.
 1. 환자의 준비 참고: ICP 센서 수술 ( 그림 1)에 의해 환자에 배치 됩니다. 센서는 경 막 외 공간, 아 공간, 실질, 또는 심 실 시스템에 배치 됩니다.
<ol><li>특정 통신 케이블을 통해 침대 모니터와 ICP 모니터링 기계 연결.</li>
	<li>환자 참조 조정 &#39; s 머리 맡, 침대 옆 모니터에서 데이터는 컴퓨터를 모니터링 하는 ICP에를 모니터링.</li>
	<li>환자에 간선 배치 수행 &#39; s 왼쪽 또는 오른쪽 요 골 동맥 20.</li>
	<li>는 baroreceptor 동맥 선 연결.</li>
	<li>환자와 압력 트랜스듀서를 연결 &#39; 통신 케이블을 통해 s 침대 모니터.</li>
	<li>실제 값과 일치 하는 측정 된 혈압을 머리 맡 모니터를 조정 하는 0.</li>
</ol> 2. 생리 적인 매개 변수의 녹음 <ol><li>환자 연결 &#39; s 침대 모니터 데이터를 수집 하 고 네트워크 케이블을 통해 장치를 저장.</li>
	<li>데이터 수집 장치를 켜려면 전원 단추를 누릅니다.</li>
	<li>Multimodality 모니터링 소프트웨어는 자동으로 실행 될 때까지 몇 초 동안 기다립니다.</li>
	<li>이름, ID, 진단 및 초기 글래스고 코 마 가늠 자 (GCS)를 포함 하 여 환자의 정보를 입력 하십시오.</li>
	<li>클릭에 &#34; 저장 하 고 모니터링을 시작 &#34; 데이터 수집 하 고 저장을 시작 하는 버튼.</li>
	<li>클릭는 &#34; 해제 &#34; 데이터 수집 ( 그림 2)의 끝에 스크린에 단추.</li>
	<li>마지막 GC를 입력 하십시오.</li>
</ol> 3. 매개 변수 분석 <ol><li>호스트에 범용 직렬 버스 (USB) 인터페이스를 통해 U-디스크에 저장 된 데이터를 덤프.</li>
	<li>사용자 이름 및 암호를 분석 서버에 로그인 입력.</li>
	<li>클릭은 &#34; 새 레코드를 만들 &#34; 버튼 하 고 업로드 하려면 U 디스크에서 데이터 파일을 선택.</li>
	<li>데이터 (데이터 크기)에 따라 분석 하기 전에 약 10 ~ 20 분을 기다립니다.</li>
	<li>클릭는 &#34; 세부 사항 &#34; 결과를 보려면 각 레코드의 버튼.</li>
	<li>클릭는 &#34; 차트 보기 &#34;을 최종 다이어그램을 참조 하십시오.</li>
	<li>자세히 볼 시간 표시 막대를 끕니다.</li>
	<li>클릭는 &#34; scattergram &#34; 매개 변수의 분포를 볼 버튼.</li>
</ol>

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금융 지원이 받았습니다.

이이 글의 목적은 새로운 multimodality 모니터링 소개 하 고 생리 적 매개 변수를 모니터링 하는 데 사용할 수, 신경외과 중요 한 환자에 대 한 분석 시스템 현재 임상 상태를 분석 하 고, 바라 건 대, 예 후 예측 신경외과 중요 한 환자. 요즘, ICP 모니터링의 초점은 부정확 또는 지연4,,521의 위험을가지고 수 있습니다 다른 매개 변수...

ICP 모니터링 널리 신경외과 부서, 특히 신경외과 중요 한 환자1,2,3intracranial 상태를 평가 하는 데 사용 됩니다. 평균 ICP 값 외는 ICP 파생 된 매개 변수 같은 ICP 파형, 앰프, 랩, PRx, IAAC, 그리고, intracerebral 순환, cerebrospinal 보상 예약의 상태를 반영 하 고 준수4,5, 뇌 수 있습니다. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13. 그들은 임박한 신경 저하 및 환자14,15,,1617,18도 결과의 표시 될 수 있습니다. 그들은 또한 적절 한 치료19의 지침으로 사용할 수 있습니다. 그러나, 대부분은 임상의는 이러한 매개 변수를 무시 하는 동안 평균 ICP 값에만 초점. 이것은 부분적으로 있기 때문에 몇 가지 특정 장치 임상 일상적인 임상 작업에 적합 합니다.
이러한 단점을 해결 하기 위해 우리는 최근에 multimodality 모니터링 시스템을 개발 했습니다. 우리는 자동 데이터 수집 하 고 저장 장치를 사용 하 여 지속적으로 혈압, ICP, 및 산소 포화, 환자의 생리 적인 정보를 취득 하 고 현재 임상 상태를 나타내기 위해 이러한 생리 적 매개 변수를 분석 하 고, 바라 건 대, 신경외과 중요 한 환자의 예 후를 예측 한다. 이 multimodality 모니터링 시스템에는 여러 이점이 있다: (1) 그것은 그것 및 녹음할 수 있습니다 여러 매개 변수, 즉, ICP 파형, PRx, 랩, IAAC, (3) 그것은 긴 기간 지속적인 모니터링, 달성할 수 있다 높은 주파수, (2) 및 (4)에서 실시간 데이터를 수집할 수 있습니다 휴대용 이며 쉽게 배울 수 있습니다.
이 문서의 목적은 따라서 multimodality 모니터링 시스템을 사용 하 여 중요 한 신경외과 환자에서 다양 한 생리 적 매개 변수를 기록 하는 방법의 상세한 방법을 보여줍니다 것입니다.

<table><tbody><tr><td>Bedside monitor</td><td>Philips</td><td>IntelliVue MP40 M8003A</td><td>With interfacing module</td></tr><tr><td>ICP monitoring machine</td><td>&amp;nbsp;Johnson &amp;amp; Johnson or Sophysa</td><td></td><td></td></tr><tr><td>Arterial cannula</td><td>BD</td><td>REF682245</td><td></td></tr><tr><td>Pressure transducer</td><td>Haisheng Medical</td><td>DBPT-0103</td><td></td></tr><tr><td>Data collection device</td><td>Shanghai Haoju</td><td>Neumatic</td><td></td></tr><tr><td>Computer</td><td></td><td></td><td>Requires Windows operating system</td></tr></tbody></table>

a detailed protocol for physiological parameters acquisition and analysis in neurosurgical critical patients

Intracranial 압력 (ICP) 모니터링은 지금 널리 이용 된다 중요 한 신경외과 환자에. 평균 ICP 값, 외는 ICP ICP 파형, 펄스 (AMP)의 진폭, ICP 진폭 및 ICP 평균 (랩)의 상관 관계 압력 반응성 인덱스 (PRx), ICP 및 동맥 혈압 (ABP) 파 진폭 (IAAC), 하 고 그래서 매개 변수를 파생 수 intracranial 상태를 반영 하 고, 예 후, 예측 하 고 적절 한 치료의 지침으로 사용할 수 있습니다. 그러나, 대부분은 임상의 현재 디바이스의 제한 때문에 이러한 매개 변수를 무시 하는 동안 평균 ICP 값에만 초점. 최근 이러한 단점을 해결 하기 위해 시스템 모니터링 multimodality를 개발 했습니다. 이 휴대용, 사용자 친화적인 시스템 데이터 수집 및 저장 하는 지속적으로 환자의 생리 적 매개 변수를 먼저 취득 하는 장치, 즉, ABP, ICP, 그리고 산소 포화 사용 되며 이러한 생리 적 매개 변수 분석. 우리는 시스템을 모니터링 multimodality 생리 적 매개 변수, 현재 임상 상태를 분석 하 고 신경외과 중요 한 환자의 예 후를 예측 하기를 모니터링 하는 데 핵심 조치로 받아들여질 것 이다 바랍니다.

이 새로운 multimodality 모니터링 시스템 22 신경외과 중요 한 환자 (15 남성)에 적용 했다. 외상 성 뇌 부상 (TBI)에서 12 (54.55%) 그들의 고통을 겪고, 그들 (40.91%)의 9 intracranial 출혈 졌고 그들 (4.55%)의 1 했다 심각한 대뇌 경색. 시간을 모니터링 하는 총 1900 h (환자 당 약 88 h)입니다. 성공적인 수술 후, 우리는 지속적으로 모니터링 하 고 그들의 ICP, 혈압, CPP, PRx, 랩, 그리고 IAAC 분석...

Watch this Scientific Journal Video about A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients at JoVE.com

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

최근, 신경외과 중요 한 환자에서 다양 한 생리 적 매개 변수 모니터링 시스템을 모니터링 하는 휴대용 multimodality를 개발 했습니다. 이 multimodality 모니터링 시스템을 사용 하는 방법에 대 한 자세한 프로토콜 여기 되 게 됩니다.

생리 적인 매개 변수에 대 한 자세한 프로토콜 수집 및 신경외과 중요 한 환자 분석

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ...

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Research

JoVE Journal

Medicine

6.8K 조회수.  Shanghai Jiaotong University School of Medicine. 최근, 신경외과 중요 한 환자에서 다양 한 생리 적 매개 변수 모니터링 시스템을 모니터링 하는 휴대용 multimodality를 개발 했습니다. 이 multimodality 모니터링 시스템을 사용 하는 방법에 대 한 자세한 프로토콜 여기 되 게 됩니다.

비디오: A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

Performing Behavioral Tasks in Subjects with Intracranial Electrodes

Patients having stereo-electroencephalography (SEEG) electrode, subdural grid or depth electrode implants have a multitude of electrodes implanted in different areas of their brain for the localization of their seizure focus and eloquent areas. After implantation, the patient must remain in the hospital until the pathological area of brain is found and possibly resected. During this time, these patients offer a unique opportunity to the research community because any number of behavioral paradigms can be performed to uncover the neural correlates that guide behavior. Here we present a method for recording brain activity from intracranial implants as subjects perform a behavioral task designed to assess decision-making and reward encoding. All electrophysiological data from the intracranial electrodes are recorded during the behavioral task, allowing for the examination of the many brain areas involved in a single function at time scales relevant to behavior. Moreover, and unlike animal studies, human patients can learn a wide variety of behavioral tasks quickly, allowing for the ability to perform more than one task in the same subject or for performing controls. Despite the many advantages of this technique for understanding human brain function, there are also methodological limitations that we discuss, including environmental factors, analgesic effects, time constraints and recordings from diseased tissue. This method may be easily implemented by any institution that performs intracranial assessments; providing the opportunity to directly examine human brain function during behavior.

Patients implanted with intracranial electrodes provide a unique opportunity to record neurological data from multiple areas of the brain while the patient performs behavioral tasks. Here, we present a method of recording from implanted patients that can be reproducible at other institutions with access to this patient population.

두개 내 전극 피사체에 행동 작업 수행

Patients having stereo-electroencephalography (SEEG) electrode, subdural grid or depth electrode implants have a multitude of electrodes implanted in ...

연구

행동분석학

Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson&#39;s disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.

The present protocol aims at assessing cognitive-emotional functions in the basal ganglia by simultaneous neurophysiological recording of local field potentials and non-invasive brain cortical activity (EEG). The procedure is exemplified by the use of paradigms involving speech stimuli with emotional connotation or the Flanker task involving cognitive control.

인간의 결합 침략 피질과인지의 평가를위한 비 침습적 표면 신경 생리학 녹음과 정서적 기능

In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging ...

Electrophysiology on Isolated Brainstem-spinal Cord Preparations from Newborn Rodents Allows Neural Respiratory Network Output Recording

While it is well known that the central respiratory drive is located in the brainstem, several aspects of its basic function, development, and response to stimuli remain to be fully understood. To overcome the difficulty of accessing the brainstem in the whole animal, isolation of the brainstem and part of the spinal cord is performed. This preparation is maintained in artificial cerebro-spinal fluid where gases, concentrations, and temperature are controlled and monitored. The output signal from the respiratory network is recorded by a suction electrode placed on the fourth ventral root. In this manner, stimuli can be directly applied onto the brainstem, and the effect can be recorded directly. The signal recorded is linked to the inspiratory signal sent to the diaphragm via the phrenic nerve, and can be described as bursts (around 8 bursts per minute). Analysis of these bursts (frequency, amplitude, length, and area under the curve) allows precise characterization of the stimulus effect on the respiratory network. The main limitation of this method is the viability of the preparation beyond the early post-natal stages. Thus, this method greatly focuses on the study of the whole network without the peripheral inputs in the newborn rat.

The central respiratory drive is located in the brainstem. Spontaneous respiratory motor output from an isolated brainstem-spinal cord is recorded by placing an electrode on the fourth ventral root. This experimental approach is valuable for pharmacological investigations or the assessment of respiratory challenges and genetic manipulations on rhythmic motor behavior.

신생아 설치류에서 분리 뇌간 - 척수 준비에 전기 생리학은 신경 호흡 네트워크 출력 녹화를 할 수 있습니다

While it is well known that the central respiratory drive is located in the brainstem, several aspects of its basic function, development, and response to ...

신경과학

Simultaneous Recordings of Cortical Local Field Potentials, Electrocardiogram, Electromyogram, and Breathing Rhythm from a Freely Moving Rat

Monitoring the physiological dynamics of the brain and peripheral tissues is necessary for addressing a number of questions about how the brain controls body functions and internal organ rhythms when animals are exposed to emotional challenges and changes in their living environments. In general experiments, signals from different organs, such as the brain and the heart, are recorded by independent recording systems that require multiple recording devices and different procedures for processing the data files. This study describes a new method that can simultaneously monitor electrical biosignals, including tens of local field potentials in multiple brain regions, electrocardiograms that represent the cardiac rhythm, electromyograms that represent awake/sleep-related muscle contraction, and breathing signals, in a freely moving rat. The recording configuration of this method is based on a conventional micro-drive array for cortical local field potential recordings in which tens of electrodes are accommodated, and the signals obtained from these electrodes are integrated into a single electrical board mounted on the animal's head. Here, this recording system was improved so that signals from the peripheral organs are also transferred to an electrical interface board. In a single surgery, electrodes are first separately implanted into the appropriate body parts and the target brain areas. The open ends of all of these electrodes are then soldered to individual channels of the electrical board above the animal's head so that all of the signals can be integrated into the single electrical board. Connecting this board to a recording device allows for the collection of all of the signals into a single device, which reduces experimental costs and simplifies data processing, because all data can be handled in the same data file. This technique will aid the understanding of the neurophysiological correlates of the associations between central and peripheral organs.

This study introduces a method for the simultaneous recording of local field potentials in the brain, electrocardiograms, electromyograms, and breathing signals of a freely moving rat. This technique, which reduces experimental costs and simplifies data analysis, will contribute to the understanding of the interactions between the brain and peripheral organs.

대뇌 피 질의 로컬 필드 전위, 심전도, 치십시오, 그리고 자유롭게 움직이는 쥐에서 리듬 호흡의 동시 녹음

Monitoring the physiological dynamics of the brain and peripheral tissues is necessary for addressing a number of questions about how the brain controls ...

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury

Intracranial pressure (ICP) monitoring is a cornerstone of the intensive care management of patients with severe acute brain injuries, including traumatic brain injury. While elevations in ICP are common, data regarding the measurement and treatment of these ICP elevations are conflicting. There is increasing recognition that changes in the balance between supply and demand of brain tissue are critically important and therefore the measurement of multiple modalities is required. Approaches are not standard, and therefore this article provides a description of a bedside, single burr hole approach to multimodality monitoring that allows the passage of probes designed to measure not only ICP but brain tissue oxygen, blood flow, and intracranial electroencephalography. Patient selection criteria, operative procedures, and practical considerations for securing probes during critical care are described. This method is readily performed, safe, secure, and flexible for the adoption of a variety of multimodality monitoring approaches aimed at detecting or preventing secondary brain injuries.

A method of recording multimodality monitoring signals in patients with severe brain injuries using a bedside, single burr hole technique is described.

머리 맡, 단일 버 구멍 접근 Multimodality 심각한 뇌 손상에서 모니터링

Intracranial pressure (ICP) monitoring is a cornerstone of the intensive care management of patients with severe acute brain injuries, including traumatic ...

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an insufficient oxygen supply and irreversible organ failure. The brain exerts only limited compensation capacities and is particularly at high risk of severe hypoxic damage.This article demonstrates the reproducible induction of life-threatening hemorrhagic shock in a porcine model by means of calculated blood withdrawal. We titrate shock induction guided by near-infrared spectroscopy&#160;and extended hemodynamic monitoring to display systemic circulatory failure, as well as cerebral microcirculatory oxygen depletion. In comparison to similar models that primarily focus on predefined removal volumes for shock induction, this approach highlights a titration by means of the resulting failure of macro- and microcirculation.

Hemorrhagic shock is a severe complication in seriously injured patients, which leads to life-threatening oxygen undersupply. We present a standardized method to induce hemorrhagic shock via blood withdrawal in pigs that is guided by hemodynamics and microcirculatory cerebral oxygenation.

돼지의 뇌산소측정및 확장된 혈역학적 모니터링에 의해 유도된 표준화된 출혈성 쇼크 유도

Hemorrhagic shock ranks among the main reasons for severe injury-related death. The loss of circulatory volume and oxygen carriers can lead to an ...

의학

Assessing Cerebral Autoregulation via Oscillatory Lower Body Negative Pressure and Projection Pursuit Regression

The process by which cerebral perfusion is maintained constant over a wide range of systemic pressures is known as &#8220;cerebral autoregulation.&#8221; Effective dampening of flow against pressure changes occurs over periods as short as ~15 sec and becomes progressively greater over longer time periods. Thus, slower changes in blood pressure are effectively blunted and faster changes or fluctuations pass through to cerebral blood flow relatively unaffected. The primary difficulty in characterizing the frequency dependence of cerebral autoregulation is the lack of prominent spontaneous fluctuations in arterial pressure around the frequencies of interest (less than ~0.07 Hz or ~15 sec). Oscillatory lower body negative pressure (OLBNP) can be employed to generate oscillations in central venous return that result in arterial pressure fluctuations at the frequency of OLBNP. Moreover, Projection Pursuit Regression (PPR) provides a nonparametric method to characterize nonlinear relations inherent in the system without a priori assumptions and reveals the characteristic non-linearity of cerebral autoregulation. OLBNP generates larger fluctuations in arterial pressure as the frequency of negative pressure oscillations become slower; however, fluctuations in cerebral blood flow become progressively lesser. Hence, the PPR shows an increasingly more prominent autoregulatory region at OLBNP frequencies of 0.05 Hz and below (20 sec cycles). The goal of this approach it to allow laboratory-based determination of the characteristic nonlinear relationship between pressure and cerebral flow and could provide unique insight to integrated cerebrovascular control as well as to physiological alterations underlying impaired cerebral autoregulation (e.g., after traumatic brain injury, stroke, etc.).

Cerebral perfusion is maintained across a range of pressures via cerebral autoregulation. However, characterizing autoregulation requires prominent pressure fluctuations at regulated frequencies. The described protocol will show how oscillatory lower body negative pressure can generate pressure fluctuations to provide data for projection pursuit regression for quantification of the autoregulatory curve.

진 동성 하체 부정적인 압력 및 프로젝션 추구 회귀 분석을 통해 뇌 혈류의자가 평가

The process by which cerebral perfusion is maintained constant over a wide range of systemic pressures is known as &#8220;cerebral autoregulation.&#8221; ...

생물학

How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children

Near infrared spectroscopy (NIRS) calculates regional tissue oxygenation (rSO2) using the different absorption spectra of oxygenated and deoxygenated hemoglobin molecules. A probe placed on the skin emits light that is absorbed, scattered, and reflected by the underlying tissue. Detectors in the probe sense the amount of reflected light: this reflects the organ-specific ratio of oxygen supply and consumption - independent of pulsatile flow. Modern devices enable the simultaneous monitoring at different body sites. A rise or dip in the rSO2 curve visualizes changes in oxygen supply or demand before vital signs indicate them. The evolution of rSO2 values in relation to the starting point is more important for interpretation than are absolute values.
A routine clinical application of NIRS is the surveillance of somatic and cerebral oxygenation during and after cardiac surgery. It is also administered in preterm infants at risk for necrotizing enterocolitis, newborns with hypoxic ischemic encephalopathy and a potential risk of impaired tissue oxygenation. In the future, NIRS could be increasingly used in multimodal neuromonitoring, or applied to monitor patients with other conditions (e.g., after resuscitation or traumatic brain injury).

This protocol is designed to assist clinicians to measure regional tissue oxygenation at different body sites in infants and children. It can be used in situations where tissue oxygenation is potentially compromised, particularly during cardiopulmonary bypass, when using non-pulsatile cardiac-assist devices, and in critically ill neonates, infants and children.

중증 신생아, 유아 및 어린이의 근적외선 분광기 관리 방법

Near infrared spectroscopy (NIRS) calculates regional tissue oxygenation (rSO2) using the different absorption spectra of oxygenated and deoxygenated ...

Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies

Neurophysiological monitoring is an important goal in the treatment of neurocritical patients, as it may prevent secondary damage and directly impact morbidity and mortality rates. However, there is currently a lack of suitable non-invasive, real-time technologies for continuous monitoring of cerebral physiology at the bedside. Diffuse optical techniques have been proposed as a potential tool for bedside measurements of cerebral blood flow and cerebral oxygenation in case of neurocritical patients. Diffuse optical spectroscopies have been previously explored to monitor patients in several clinical scenarios ranging from neonatal monitoring to cerebrovascular interventions in adults. However, the feasibility of the technique to aid clinicians by providing real-time information at the bedside remains largely unaddressed. Here, we report the translation of a diffuse optical system for continuous real-time monitoring of cerebral blood flow, cerebral oxygenation, and cerebral oxygen metabolism during intensive care. The real-time feature of the instrument could enable treatment strategies based on patient-specific cerebral physiology rather than relying on surrogate metrics, such as arterial blood pressure. By providing real-time information on the cerebral circulation at different time scales with relatively cheap and portable instrumentation, this approach may be especially useful in low-budget hospitals, in remote areas and for&#160;monitoring in open fields (e.g., defense and sports).

Presented here is a protocol for non-invasively monitoring cerebral hemodynamics of neurocritical patients in real-time and at the bedside using diffuse optics. Specifically, the proposed protocol uses a hybrid diffuse optical systems to detect and display real-time information on cerebral oxygenation, cerebral blood flow and cerebral metabolism.

확산 광학 분광법을 이용한 신경중증 환자의 실시간 모니터링

Neurophysiological monitoring is an important goal in the treatment of neurocritical patients, as it may prevent secondary damage and directly impact ...

Intra-Abdominal Pressure Measurements in Neurocritical Patients

Intra-abdominal pressure (IAP) is increasingly being recognized as an indispensable and significant physiological parameter in intensive care units (ICU). IAP has been measured in a variety of ways with the development of many techniques in recent years. The level of intra-abdominal pressure under normal conditions is generally equal to or less than 12 mmHg. Accordingly, abdominal hypertension (IAH) is defined as two consecutive IAP measurements higher than 12 mmHg within 4-6 h. When IAH deteriorates further with IAP higher than 20 mmHg along with organ dysfunction and/or failure, this clinical manifestation can be diagnosed as abdominal compartment syndrome (ACS). IAH and ACS are associated with gastrointestinal ischemia, acute renal failure, and lung injury, leading to severe morbidity and mortality. Elevated IAP and IAH may affect the cerebral venous return and outflow of the cerebrospinal fluid by increasing the intrathoracic pressure (ITP), ultimately leading to increased intracranial pressure (ICP). Therefore, it is essential to monitor IAP in critically ill patients. The reproducibility and accuracy of intra-bladder pressure (IBP) measurements in previous studies need to be further improved, although the indirect measurement of IAP is now a widely used technique. To address these limitations, we recently used a set of IAP monitoring systems with advantages of convenience, continuous monitoring, digital visualization, and long-term IAP recording and data storage in critically ill patients. This IAP monitoring system can detect intra-abdominal hypertension and potentially analyze clinical status in real time. The recorded IAP data and other physiological indicators, such as intracranial pressure, can be further used for correlation analysis to guide treatment and predict a patient&#39;s possible prognosis.

This protocol details the use of a set of intra-abdominal pressure monitoring systems with advantages of convenience, continuous monitoring, digital visualization, and long-term IAP recording and data storage in neurocritical patients to detect intra-abdominal hypertension, which is used for correlation analysis to guide treatment and predict prognoses.

Intra-abdominal pressure (IAP) is increasingly being recognized as an indispensable and significant physiological parameter in intensive care units (ICU). ...