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.

Subarachnoid Haemorrhage

Classically, brain monitoring after SAH can be divided into the time spent on the ICU, with the patient supported by ventilation, and afterwards. Brain monitoring in the ICU does not differ generally from monitoring after TBI. After the ICU period, monitoring is mainly focused on the search of vasospasm and autoregulation of blood flow, mainly using transcranial Doppler ultrasonography (TCD) or near-infrared spectroscopy (NIRS).

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Traumatic Brain Injury

Multimodal brain monitoring data collection after TBI includes various modalities such as ICP, CPP, brain tissue oxygenation, cerebral blood flow, microdialysis, etc. Various secondary indices like PRx, autoregulation indices, and compensatory reserve index (RAP), developed using ICM+ software, have been suggested in the literature as potentially helpful for management of TBI patients to avoid secondary brain insults.

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