The following is a summary of “Practice Standards for the Use of Multimodality Neuromonitoring: A Delphi Consensus Process,” published in the August 2023 issue of Critical Care by Foreman, et al.
Researchers started a retrospective study to identify areas of consensus and disagreement on technologies, effort, and training necessary for multimodality neuromonitoring (MNM) integration and interpretation.
They conducted a three-round Delphi consensus process involving electronic surveys and virtual meetings with participants possessing extensive MNM expertise from adult and pediatric intensive care backgrounds.
The results showed a two-round survey process followed by a virtual meeting and a final survey in which 35 participants achieved consensus on 49% of MNM-related statements. Clinical considerations regarding neurologic impairment and the potential for MNM to inform management were crucial. Experts agreed on using both invasive and noninvasive MNM for patients in a coma with traumatic brain injury, aneurysmal subarachnoid hemorrhage, and intracranial hemorrhage. It was also agreed upon that integrating and interpreting MNM requires dedicated time, specific skills, and expertise separate from daily clinical duties. Additionally, consensus emphasized the need for training and educational platforms to develop knowledge and ensure clinical correlation.
Investigators concluded that expert consensus on clinical considerations, technologies, implementation, and training/education provides practice standards for individualized MNM use.
Source: journals.lww.com/ccmjournal/abstract/9900/practice_standards_for_the_use_of_multimodality.193.aspx