Acute Brain Injury

The injured brain generally needs intensive treatment on the ICU. Due to anaesthesia, monitoring of neurological signs is impossible; therefore, multi-parameter brain monitoring plays an important role. One of the exciting methodologies that came out of ICM+ powered research is a concept of ‘optimal CPP’, a strategy which theoretically could minimise the risk of autoregulation failure.

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Miscellaneous Clinical Research

Various areas of miscellaneous clinical research are creatively supported by dedicated ICM+ functions.

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Laboratory Applications

Multimodal monitoring in the laboratory requires computer support. Various protocols in different centres have been used. Apart from classical signals like in TBI, monitors like laser Doppler flowmetry, rheoencephalography, NIRS, diffused correlation spectroscopy, etc., are verified. Various novel secondary indices can be designed and tested in an experimental environment.

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Neonatal

Preterm birth is associated with mortality and long-term disabilities. Despite the advances in neonatal medicine in the last 20 years, brain injury remains a burden for those infants who survive. Non-invasive methods based on near-infrared spectroscopy (NIRS) brain monitoring could potentially be used for optimising neonatal care and improving neurological outcome for preterm infants, including determination of optimal blood pressure, avoiding ischemia, or the risk of brain haemorrhage. ICM+ provides tools for exploration and development of those ideas.

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Non-Invasive Brain Monitoring methodologies

Non-invasive indices are mainly based on TCD and NIRS monitoring. Multi-parametric TCD (in conjunction with arterial blood pressure) may include: autoregulation indices, non-invasive ICP and CPP, critical closing pressure, and the cerebrovascular time constant (TAU). NIRS is ideal for long-term, non-invasive monitoring of cerebral autoregulation.

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Stroke

Ischemic stroke affects blood flow in cerebral arteries. Techniques like TCD allow the calculation of various autoregulation indices and continuous assessment of critical closing pressure.

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