The following is a summary of “Multimodal monitoring in patients with acute brain injury—A survey from critical care providers,” published in the March 2024 issue of Critical Care by Klavansky et al.
Multimodal neuromonitoring (MMM) is a developing approach in Neurocritical Care Units that uses various tools to improve outcomes after brain injury. Still, the best combination and use of these tools must be determined.
Researchers conducted a retrospective study identifying the most common invasive and non-invasive neuromonitoring practices and assessing the prevalence of standardized protocols for MMM in neurocritical care.
They conducted a cross-sectional survey to explore the current availability and protocolized implementation of MMM among neurocritical care units in US and non-US intensive care units. The survey comprised a self-administered online questionnaire containing 20 closed-ended questions. The Neurocritical Care Society disseminated the questionnaire.
The results showed that twenty-one critical care practitioners participated in the survey, achieving a completion rate of 76%. The most commonly utilized non-invasive neuromonitoring modalities were continuous electroencephalography (cEEG), followed by transcranial Doppler. Invasive modalities included external ventricular drain and monitoring of parenchymal intracranial pressure (ICP). MMM was predominantly used in patients with subarachnoid hemorrhage. No discrepancies existed in established institutional protocol, 24-hour cEEG availability, and invasive monitor placement between teaching and non-teaching hospitals. MMM was the standard of care in 28% of surveyed hospitals, while 26.7% considered it experimental and performed solely in clinical trials. Only 26.7% of hospitals used a computerized data integration system.
Investigators concluded that the survey identified limited overall use of MMM and an absence of standardized protocols across institutions, suggesting a need for further research and standardization to determine its impact on severe patients with brain injury.
Source: sciencedirect.com/science/article/abs/pii/S0883944124002934
