Name: a detailed protocol for physiological parameters acquisition and analysis in neurosurgical critical patients
Uploaded: 2017-10-17T13:00:00
Description: Watch this Scientific Journal Video about A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients at JoVE.com

Vi vil gerne anerkende alle kolleger i NICU for deres arbejde.

denne protokol blev godkendt af den institutionelle Review Board af Renji Hospital, Shanghai Jiaotong University School of Medicine.
 1. forberedelse af patienten Bemærk: ICP sensor er placeret i patienten ved et kirurgisk indgreb ( figur 1). Sensoren placeres i epiduralrummet, subduralt rummet, parenkym eller ventrikulære systemet.
<ol><li>Forbinde ICP overvågning maskinen med den sengelamper skærm via en specifik kommunikation...

<ol>
	<li>Hawthorne, C., Piper, I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+of+intracranial+pressure+in+patients+with+traumatic+brain+injury.">Monitoring of intracranial pressure in patients with traumatic brain injury.</a> Front Neurol. 5, 121 (2014).</li><li>Cooper, D. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Decompressive+craniectomy+in+diffuse+traumatic+brain+injury.">Decompressive craniectomy in diffuse traumatic brain injury.</a> N Engl J Med. 364 (16), 1493-1502 (2011).</li><li>Jiang, J. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Head+trauma+in+China.">Head trauma in China.</a> Injury. 44 (11), 1453-1457 (2013).</li><li>Hu, X., Xu, P., Asgari, S., Vespa, P., Bergsneider, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Forecasting+ICP+elevation+based+on+prescient+changes+of+intracranial+pressure+waveform+morphology.">Forecasting ICP elevation based on prescient changes of intracranial pressure waveform morphology.</a> IEEE Trans Biomed Eng. 57 (5), 1070-1078 (2010).</li><li>Di Ieva, A., Schmitz, E. M., Cusimano, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+intracranial+pressure:+past,+present,+and+future.">Analysis of intracranial pressure: past, present, and future.</a> Neuroscientist. 19 (6), 592-603 (2013).</li><li>Czosnyka, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intracranial+pressure:+more+than+a+number.">Intracranial pressure: more than a number.</a> Neurosurg Focus. 22 (5), 10 (2007).</li><li>Lu, C. W., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Complexity+of+intracranial+pressure+correlates+with+outcome+after+traumatic+brain+injury.">Complexity of intracranial pressure correlates with outcome after traumatic brain injury.</a> Brain. 135 (8), 2399-2408 (2012).</li><li>Nucci, C. G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intracranial+pressure+wave+morphological+classification:+automated+analysis+and+clinical+validation.">Intracranial pressure wave morphological classification: automated analysis and clinical validation.</a> Acta Neurochir (Wien). 158 (3), 581-588 (2016).</li><li>Eide, P. K., Sorteberg, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Association+among+intracranial+compliance,+intracranial+pulse+pressure+amplitude+and+intracranial+pressure+in+patients+with+intracranial+bleeds.">Association among intracranial compliance, intracranial pulse pressure amplitude and intracranial pressure in patients with intracranial bleeds.</a> Neurol Res. 29 (8), 798-802 (2007).</li><li>Czosnyka, M., Czosnyka, Z. H., Whitfield, P. C., Donovan, T., Pickard, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Age+dependence+of+cerebrospinal+pressure-volume+compensation+in+patients+with+hydrocephalus.">Age dependence of cerebrospinal pressure-volume compensation in patients with hydrocephalus.</a> J Neurosurg. 94 (3), 482-486 (2001).</li><li>Howells, T., Lewen, A., Skold, M. K., Ronne-Engstrom, E., Enblad, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=An+evaluation+of+three+measures+of+intracranial+compliance+in+traumatic+brain+injury+patients.">An evaluation of three measures of intracranial compliance in traumatic brain injury patients.</a> Intensive Care Med. 38 (6), 1061-1068 (2012).</li><li>Schuhmann, M. U., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Value+of+overnight+monitoring+of+intracranial+pressure+in+hydrocephalic+children.">Value of overnight monitoring of intracranial pressure in hydrocephalic children.</a> Pediatr Neurosurg. 44 (4), 269-279 (2008).</li><li>Czosnyka, M., Pickard, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+and+interpretation+of+intracranial+pressure.">Monitoring and interpretation of intracranial pressure.</a> J Neurol Neurosurg Psychiatry. 75 (6), 813-821 (2004).</li><li>Sorrentino, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Critical+thresholds+for+cerebrovascular+reactivity+after+traumatic+brain+injury.">Critical thresholds for cerebrovascular reactivity after traumatic brain injury.</a> Neurocrit Care. 16 (2), 258-266 (2012).</li><li>Carrera, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+shapes+pulse+amplitude+of+intracranial+pressure.">What shapes pulse amplitude of intracranial pressure.</a> J Neurotrauma. 27 (2), 317-324 (2010).</li><li>Eide, P. K., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pressure-derived+versus+pressure+wave+amplitude-derived+indices+of+cerebrovascular+pressure+reactivity+in+relation+to+early+clinical+state+and+12-month+outcome+following+aneurysmal+subarachnoid+hemorrhage.">Pressure-derived versus pressure wave amplitude-derived indices of cerebrovascular pressure reactivity in relation to early clinical state and 12-month outcome following aneurysmal subarachnoid hemorrhage.</a> J Neurosurg. 116 (5), 961-971 (2012).</li><li>Lazaridis, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Patient-specific+thresholds+of+intracranial+pressure+in+severe+traumatic+brain+injury.">Patient-specific thresholds of intracranial pressure in severe traumatic brain injury.</a> J Neurosurg. 120 (4), 893-900 (2014).</li><li>Czosnyka, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+and+interpretation+of+intracranial+pressure+after+head+injury.">Monitoring and interpretation of intracranial pressure after head injury.</a> Acta Neurochir Suppl. 96, 114-118 (2006).</li><li>Steiner, L. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Continuous+monitoring+of+cerebrovascular+pressure+reactivity+allows+determination+of+optimal+cerebral+perfusion+pressure+in+patients+with+traumatic+brain+injury.">Continuous monitoring of cerebrovascular pressure reactivity allows determination of optimal cerebral perfusion pressure in patients with traumatic brain injury.</a> Crit Care Med. 30 (4), 733-738 (2002).</li><li>Tegtmeyer, K., Brady, G., Lai, S., Hodo, R., Braner, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Videos+in+Clinical+Medicine.+Placement+of+an+arterial+line.">Videos in Clinical Medicine. Placement of an arterial line.</a> N Engl J Med. 354 (15), 13 (2006).</li><li>Chesnut, R. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+trial+of+intracranial-pressure+monitoring+in+traumatic+brain+injury.">A trial of intracranial-pressure monitoring in traumatic brain injury.</a> N Engl J Med. 367 (26), 2471-2481 (2012).</li></ol>

Denne formålet med denne artikel er at introducere den nye multimodalitet overvågning og analyse system for neurokirurgiske kritiske patienter, som kan bruges til at overvåge fysiologiske parametre, analysere den nuværende kliniske status og forhåbentlig, forudsige prognosen af de neurokirurgiske kritiske patienter. I dag er er fokus for ICP overvågning hovedsagelig på gennemsnitlige ICP værdi mens ignorerer andre parametre, som må bære risikoen for unøjagtigheder eller forsinkelse4<sup...

ICP overvågning er almindeligt anvendt til at evaluere intrakraniel status i Neurokirurgi afdeling, især i neurokirurgiske kritiske patienter1,2,3. Udover middelværdien ICP afledt ICP parametre såsom ICP bølgeform, AMP, RAP, PRx, IAAC og så videre, kan afspejler status for intracerebralt omsætning, cerebrospinal kompenserende reserve, og hjernen overholdelse4,5, 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13. de kan være et tegn på forestående neurologisk forværring og selv resultatet af patienter14,15,16,17,18. De kan også bruges som vejledning i korrekt behandling19. Men de fleste af klinikerne fokuserer udelukkende på ICP middelværdien mens ignorerer disse parametre. Dette skyldes dels, at der er nogle bestemte enheder, der er egnet til klinikere i det daglige kliniske arbejde.
For at løse disse ulemper, har vi for nylig udviklet en multimodalitet overvågningssystem. Vi bruger en automatisk data indsamling og lagring enhed til løbende erhverve patienternes fysiologiske oplysninger såsom blodtryk, ICP og iltmætning og analysere disse fysiologiske parametre for at afsløre den nuværende kliniske status og forhåbentlig, forudsige prognosen for de neurokirurgiske kritiske patienter. Denne multimodalitet kontrolsystem har flere fordele: (1) det kan indsamle data i realtid på høj frekvens, (2) det kan optage flere parametre, dvs., ICP bølgeform, PRx, RAP og IAAC, (3) det kan opnå lange sigt kontinuerlig overvågning, og (4) Det er transportabel og nem at lære.
Formålet med denne artikel, er derfor at vise en detaljeret metode til hvordan multimodalitet overvågningssystem til at registrere forskellige fysiologiske parametre i neurokirurgiske kritiske patienter.

<table style="border-collapse:collapse;width:639pt" width="852">
	<colgroup>
		<col style="width:136pt" width="181" />
		<col style="width:171pt" width="228" />
		<col style="width:134pt" width="179" />
		<col style="width:198pt" width="264" />
	</colgroup>
	<tbody>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="width:136pt;height:15.75pt" width="181">Bedside monitor</td>
			<td style="width:171pt" width="228">Philips</td>
			<td style="width:134pt" width="179">IntelliVue MP40 M8003A</td>
			<td style="width:198pt" width="264">With interfacing module</td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">ICP monitoring machine</td>
			<td>&#160;Johnson &#38; Johnson or Sophysa</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Arterial cannula</td>
			<td>BD</td>
			<td>REF682245</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Pressure transducer</td>
			<td>Haisheng Medical</td>
			<td>DBPT-0103</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Data collection device</td>
			<td>Shanghai Haoju</td>
			<td>Neumatic</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">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

Intrakranielt tryk (ICP) overvågning er nu meget udbredt i neurokirurgiske kritiske patienter. Udover betyder ICP værdi afledt ICP parametre såsom ICP bølgeform, amplitude af pulse (AMP), korrelation af ICP amplitude og ICP middelværdi (RAP), tryk og reaktivitet indeks (PRx), ICP og arterielle blodtryk (ABP) bølge amplitude korrelation (IAAC), og så på, kan afspejle intrakraniel status, forudsige prognose, og kan også bruges som vejledning i korrekt behandling. Men de fleste af klinikerne fokuserer udelukkende på ICP middelværdien mens ignorerer disse parametre på grund af begrænsninger i de nuværende enheder. Vi har for nylig udviklet en multimodalitet overvågningssystem for at afhjælpe disse ulemper. Denne bærbare, brugervenlige system vil bruge en data indsamling og lagring enhed til løbende erhverve patienternes fysiologiske parametre først, dvs, ABP, ICP og iltmætning og derefter analysere disse fysiologiske parametre. Vi håber, at multimodalitet overvågningssystem vil blive accepteret som en vigtig foranstaltning til at overvåge fysiologiske parametre, til at analysere de nuværende kliniske status og forudsige prognosen for de neurokirurgiske kritiske patienter.

Denne nye multimodalitet overvågningssystem blev anvendt på 22 neurokirurgiske kritiske patienter (15 hanner). 12 af dem (54.55%) havde ramt af traumatisk hjerneskade (TBI), 9 af dem (40.91%) havde intrakraniel blødning og 1 af dem (4.55%) havde svær cerebral infarkt. Den samlede overvågning tid er mere end 1.900 h (omkring 88 h pr. patient). Efter vellykket kirurgi, vi løbende overvåget og analyseret deres ICP, BP, CPP, PRx, RAP og IAAC. Figur 3 viser...

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

For nylig, har vi udviklet en transportabel multimodalitet overvågningssystem til kontrol med forskellige fysiologiske parametre i neurokirurgiske kritiske patienter. Detaljerede protokoller om hvordan man bruger denne multimodalitet overvågningssystem præsenteres her.

En detaljeret protokol for fysiologiske parametre erhvervelse og analyse i neurokirurgiske kritiske patienter

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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