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dc.contributor.authorJones, S.
dc.contributor.authorSchwartzbauer, G.
dc.contributor.authorJia, X.
dc.date.accessioned2019-10-08T19:43:48Z
dc.date.available2019-10-08T19:43:48Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85008214533&doi=10.3390%2fijms18010043&partnerID=40&md5=bca87abd5a4a939373c402b9428ed9d1
dc.identifier.urihttp://hdl.handle.net/10713/11069
dc.description.abstractAssessment of neurologic injury and the evolution of severe neurologic injury is limited in comatose or critically ill patients that lack a reliable neurologic examination. For common yet severe pathologies such as the comatose state after cardiac arrest, aneurysmal subarachnoid hemorrhage (aSAH), and severe traumatic brain injury (TBI), critical medical decisions are made on the basis of the neurologic injury. Decisions regarding active intensive care management, need for neurosurgical intervention, and withdrawal of care, depend on a reliable, high-quality assessment of the true state of neurologic injury, and have traditionally relied on limited assessments such as intracranial pressure monitoring and electroencephalogram. However, even within TBI there exists a spectrum of disease that is likely not captured by such limited monitoring and thus a more directed effort towards obtaining a more robust biophysical signature of the individual patient must be undertaken. In this review, multimodal monitoring including the most promising serum markers of neuronal injury, cerebral microdialysis, brain tissue oxygenation, and pressure reactivity index to access brain microenvironment will be discussed with their utility among specific pathologies that may help determine a more complete picture of the neurologic injury state for active intensive care management and long-term outcomes. Goal-directed therapy guided by a multi-modality approach appears to be superior to standard intracranial pressure (ICP) guided therapy and should be explored further across multiple pathologies. Future directions including the application of optogenetics to evaluate brain injury and recovery and even as an adjunct monitoring modality will also be discussed. Copyright 2016 by the authors.en_US
dc.description.sponsorshipThe work was supported by R01HL118084 from NIHNational Institutes of Health.en_US
dc.description.urihttps://doi.org/10.3390/ijms18010043en_US
dc.language.isoen_USen_US
dc.publisherMDPI AGen_US
dc.relation.ispartofInternational Journal of Molecular Sciences
dc.subjectBrain monitoringen_US
dc.subjectBrain tissue oxygenationen_US
dc.subjectCerebral microdialysisen_US
dc.subjectMultimodality monitoringen_US
dc.subjectOptogeneticsen_US
dc.subjectPressure reactivity indexen_US
dc.subjectSerum biomarkeren_US
dc.titleBrain monitoring in critically neurologically impaired patientsen_US
dc.typeArticleen_US
dc.identifier.doi10.3390/ijms18010043
dc.identifier.pmid28035993


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