Application of intracranial pressure monitoring technique in the treatment of traumatic brain injury

doi:10.3877/cma.j.issn.2095-9141.2023.04.009

Abstract

Abstract:

Intracranial pressure (ICP) is the pressure exerted by the contents of the skull cavity on the wall of the skull cavity. When ICP levels continue to increase in patients with traumatic brain injury (TBI), it may cause a series of nerve damage, and even lead to brain herniation leading to respiratory and circulatory failure and death. The emergence of multi-modal monitoring technology based on ICP monitoring enables clinicians to dynamically and real-time monitor the changes of ICP and related parameters in the treatment of TBI patients. At present, invasive monitoring techniques mainly focus on ventricular type ICP monitoring, with the most accurate results; while many new non-invasive monitoring techniques have also been widely concerned and studied. This article mainly reviews the application of multimodal ICP monitoring technology in TBI treatment, and compares the advantages and disadvantages of various monitoring technologies based on literature, providing a basis for clinical selection of corresponding monitoring methods.

Key words: Traumatic brain injury, Intracranial pressure, Multi-modal monitoring technology, Transcranial doppler

Xinyue Zhang, Shuai Han, Shushi Zhang, Wenchen Li, Shuyan Zhang. Application of intracranial pressure monitoring technique in the treatment of traumatic brain injury[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2023, 09(04): 246-252.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsjcswkdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-9141.2023.04.009

https://zhsjcswkdzzz.cma-cmc.com.cn/EN/Y2023/V09/I04/246

Figures/Tables 1

References 56

[1]	Meyfroidt G, Bouzat P, Casaer MP, et al. Management of moderate to severe traumatic brain injury: an update for the intensivist[J]. Intensive Care Med, 2022, 48(6): 649-666. DOI: 10.1007/s00134-022-06702-4.
[2]	Rakhit S, Nordness MF, Lombardo SR, et al. Management and Challenges of Severe Traumatic Brain Injury[J]. Semin Respir Crit Care Med, 2021, 42(1): 127-144. DOI: 10.1055/s-0040-1716493.
[3]	Han J, Yang S, Zhang C, et al. Impact of intracranial pressure monitoring on prognosis of patients with severe traumatic brain injury: a PRISMA systematic review and meta-analysis[J]. Medicine (Baltimore), 2016, 95(7): e2827. DOI: 10.1097/MD.0000000000002827.
[4]	Tas J, Czosnyka M, Van Der Horst ICC, et al. Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: a narrative review[J]. Front Physiol, 2022, 13: 1071161. DOI: 10.3389/fphys.2022.1071161.
[5]	Wijdicks EFM. Lundberg and his Waves[J]. Neurocrit Care, 2019, 31(3): 546-549. DOI: 10.1007/s12028-019-00689-5.
[6]	中国医师协会神经外科医师分会、中国神经创伤专家委员会.中国颅脑创伤颅内压监测专家共识[J].中华神经外科杂志, 2011, 27(10): 1073-1074. DOI: 10.3760/cma.j.issn.1001-2346.2011.10.033.
[7]	Wolthers SA, Engelholm CP, Uslu B, et al. Noninvasive intracranial pressure monitoring in central nervous system infections[J]. Minerva Anestesiol, 2023, 89(3): 206-216. DOI: 10.23736/S0375-9393.22.16863-X.
[8]	张尚明,胡晓芳,陈宏颉,等.脑室型颅内压监测在颅脑外伤后脑疝患者梯度减压术中的应用价值分析[J].中华神经医学杂志, 2021, 20(5): 488-494. DOI: 10.3760/cma.j.cn115354-20210112-00024.
[9]	Cremer OL. Does ICP monitoring make a difference in neurocritical care?[J]. Eur J Anaesthesiol Suppl, 2008, 42: 87-93. DOI: 10.1017/S0265021507003237.
[10]	Pelah AI, Zakrzewska A, Calviello LA, et al. Accuracy of intracranial pressure monitoring-single centre observational study and literature review[J]. Sensors (Basel), 2023, 23(7): 3397. DOI: 10.3390/s23073397. DOI: 10.1016/j.accpm.2017.12.001.
[11]	Geeraerts T, Velly L, Abdennour L, et al. Management of severe traumatic brain injury (first 24hours)[J]. Anaesth Crit Care Pain Med, 2018, 37(2): 171-186. DOI: 10.1016/j.accpm.2017.12.001.
[12]	Kasprowicz M, Lalou DA, Czosnyka M, et al. Intracranial pressure, its components and cerebrospinal fluid pressure-volume compensation[J]. Acta Neurol Scand, 2016, 134(3): 168-180. DOI: 10.1111/ane.12541.
[13]	Zhu J, Shan Y, Li Y, et al. Spindle wave in intracranial pressure signal analysis for patients with traumatic brain injury: a single-center prospective observational cohort study[J]. Front Physiol, 2022, 13: 1043328. DOI: 10.3389/fphys.2022.1043328.
[14]	Kirkman MA, Smith M. Intracranial pressure monitoring, cerebral perfusion pressure estimation, and ICP/CPP-guided therapy: a standard of care or optional extra after brain injury?[J]. Br J Anaesth, 2014, 112(1): 35-46. DOI: 10.1093/bja/aet418.
[15]	Hasen M, Gomez A, Froese L, et al. Alternative continuous intracranial pressure-derived cerebrovascular reactivity metrics in traumatic brain injury: a scoping overview[J]. Acta Neurochir (Wien), 2020, 162(7): 1647-1662. DOI: 10.1007/s00701-020-04378-7.
[16]	Young AMH, Guilfoyle MR, Donnelly J, et al. Multimodality neuromonitoring in severe pediatric traumatic brain injury[J]. Pediatr Res, 2018, 83(1-1): 41-49. DOI: 10.1038/pr.2017.215.
[17]	Zhong JI, Li Y, Minhui X, et al. Realization of a comprehensive non-invasive detection of intracranial pressure analyzer based upon FVEP and TCD[J]. Acta Neurochir Suppl, 2012, 114: 127-129. DOI: 10.1007/978-3-7091-0956-4_23.
[18]	Zeiler FA, Czosnyka M, Smielewski P. Optimal cerebral perfusion pressure via transcranial Doppler in TBI: application of robotic technology[J]. Acta Neurochir (Wien), 2018, 160(11): 2149-2157. DOI: 10.1007/s00701-018-3687-5.
[19]	Padayachy LC, Figaji AA, Bullock MR. Intracranial pressure monitoring for traumatic brain injury in the modern era[J]. Childs Nerv Syst, 2010, 26(4): 441-452. DOI: 10.1007/s00381-009-1034-0.
[20]	Brandstätter H, Schulz P, Polunic I, et al. Purification and biochemical characterization of functional complement factor H from human plasma fractions[J]. Vox Sang, 2012, 103(3): 201-212. DOI: 10.1111/j.1423-0410.2012.01610.x.
[21]	Koziarz A, Sne N, Kegel F, et al. Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure: a systematic review and meta-analysis protocol[J]. BMJ Open, 2017, 7(8): e016194. DOI: 10.1136/bmjopen-2017-016194.
[22]	Miller MT, Pasquale M, Kurek S, et al. Initial head computed tomographic scan characteristics have a linear relationship with initial intracranial pressure after trauma[J]. J Trauma, 2004, 56(5): 967-972; discussion 972-973. DOI: 10.1097/01.ta.0000123699.16465.8b.
[23]	Zhao YL, Zhou JY, Zhu GH. Clinical experience with the noninvasive ICP monitoring system[J]. Acta Neurochir Suppl, 2005, 95: 351-355. DOI: 10.1007/3-211-32318-x_72.
[24]	Herklots MW, Moudrous W, Oldenbeuving A, et al. Prospective evaluation of noninvasive headSense intracranial pressure monitor in traumatic brain injury patients undergoing invasive intracranial pressure monitoring[J]. World Neurosurg, 2017, 106: 557-562. DOI: 10.1016/j.wneu.2017.07.022.
[25]	Shanahan R, Avsar P, Watson C, et al. The impact of brain tissue oxygenation monitoring on the Glasgow outcome scale/Glasgow outcome scale extended in patients with moderate to severe traumatic brain injury: a systematic review[J]. Nurs Crit Care, 2023, Online ahead of print. DOI: 10.1111/nicc.12973.
[26]	Oddo M, Bösel J. Monitoring of brain and systemic oxygenation in neurocritical care patients[J]. Neurocrit Care, 2014, 21 Suppl 2: S103-S120. DOI: 10.1007/s12028-014-0024-6.
[27]	Skrifvars MB, Sekhon M, Åneman EA. Monitoring and modifying brain oxygenation in patients at risk of hypoxic ischaemic brain injury after cardiac arrest[J]. Crit Care, 2021, 25(1): 312. DOI: 10.1186/s13054-021-03678-3.
[28]	Guilfoyle MR, Helmy A, Donnelly J, et al. Characterising the dynamics of cerebral metabolic dysfunction following traumatic brain injury: a microdialysis study in 619 patients[J]. PLoS One, 2021, 16(12): e0260291. DOI: 10.1371/journal.pone.0260291.
[29]	Friedman D, Claassen J, Hirsch LJ. Continuous electroencephalogram monitoring in the intensive care unit[J]. Anesth Analg, 2009, 109(2): 506-523. DOI: 10.1213/ane.0b013e3181a9d8b5.
[30]	Nagai H, Moritake K, Takaya M. Correlation between transcranial Doppler ultrasonography and regional cerebral blood flow in experimental intracranial hypertension[J]. Stroke, 1997, 28(3): 603-607; discussion 608. DOI: 10.1161/01.str.28.3.603.
[31]	Singer KE, Wallen TE, Jalbert T, et al. Efficacy of noninvasive technologies in triaging traumatic brain injury and correlating with intracranial pressure: a prospective study[J]. J Surg Res, 2021, 262: 27-37. DOI: 10.1016/j.jss.2020.12.042.
[32]	Bonow RH, Young CC, Bass DI, et al. Transcranial Doppler ultrasonography in neurological surgery and neurocritical care[J]. Neurosurg Focus, 2019, 47(6): E2. DOI: 10.3171/2019.9.FOCUS19611.
[33]	Varsos GV, Kolias AG, Smielewski P, et al. A noninvasive estimation of cerebral perfusion pressure using critical closing pressure[J]. J Neurosurg, 2015, 123(3): 638-648. DOI: 10.3171/2014.10.JNS14613.
[34]	Kasuga Y, Nagai H, Hasegawa Y, et al. Transmission characteristics of pulse waves in the intracranial cavity of dogs[J]. J Neurosurg, 1987, 66(6): 907-914. DOI: 10.3171/jns.1987.66.6.0907.
[35]	Rasulo FA, Bertuetti R. Transcranial Doppler and optic nerve sonography[J]. J Cardiothorac Vasc Anesth, 2019, 33 Suppl 1: S38-S52.
[36]	Oertel MF, Scharbrodt W, Wachter D, et al. Arteriovenous differences of oxygen and transcranial Doppler sonography in the management of aneurysmatic subarachnoid hemorrhage[J]. J Clin Neurosci, 2008, 15(6): 630-636. DOI: 10.1016/j.jocn.2007.04.003.
[37]	Jeon JP, Lee SU, Kim SE, et al. Correlation of optic nerve sheath diameter with directly measured intracranial pressure in Korean adults using bedside ultrasonography[J]. PLoS One, 2017, 12(9): e0183170. DOI: 10.1371/journal.pone.0183170.
[38]	Maissan IM, Dirven PJ, Haitsma IK, et al. Ultrasonographic measured optic nerve sheath diameter as an accurate and quick monitor for changes in intracranial pressure[J]. J Neurosurg, 2015, 123(3): 743-747. DOI: 10.3171/2014.10.JNS141197.
[39]	Swanson JW, Aleman TS, Xu W, et al. Evaluation of optical coherence tomography to detect elevated intracranial pressure in children[J]. JAMA Ophthalmol, 2017, 135(4): 320-328. DOI: 10.1001/jamaophthalmol.2017.0025.
[40]	Thomas R, Shin SS, Balu R. Applications of near-infrared spectroscopy in neurocritical care[J]. Neurophotonics, 2023, 10(2): 023522. DOI: 10.1117/1.NPh.10.2.023522.
[41]	Hvedstrup J, Radojicic A, Moudrous W, et al. Intracranial pressure: a comparison of the noninvasive headSense monitor versus lumbar pressure measurement[J]. World Neurosurg, 2018, 112: e576-e580. DOI: 10.1016/j.wneu.2018.01.089.
[42]	Carney N, Totten AM, O'reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition[J]. 2017, 80(1): 6-15. DOI: 10.1227/NEU.0000000000001432.
[43]	Bernard F, Barsan W, Diaz-Arrastia R, et al. Brain oxygen optimization in severe traumatic brain injury (BOOST-3): a multicentre, randomised, blinded-endpoint, comparative effectiveness study of brain tissue oxygen and intracranial pressure monitoring versus intracranial pressure alone[J]. BMJ Open, 2022, 12(3): e060188. DOI: 10.1136/bmjopen-2021-060188.
[44]	Chesnut R, Aguilera S, Buki A, et al. A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle international severe traumatic brain injury consensus conference (SIBICC)[J]. Intensive Care Med, 2020, 46(5): 919-929. DOI: 10.1007/s00134-019-05900-x.
[45]	Mathieu F, Khellaf A, Ku JC, et al. Continuous near-infrared spectroscopy monitoring in adult traumatic brain Injury: a systematic review[J]. J Neurosurg Anesthesiol, 2020, 32(4): 288-299. DOI: 10.1097/ANA.0000000000000620.
[46]	Lindblad C, Raj R, Zeiler FA, et al. Current state of high-fidelity multimodal monitoring in traumatic brain injury[J]. Acta Neurochir (Wien), 2022, 164(12): 3091-3100. DOI: 10.1007/s00701-022-05383-8.
[47]	Timofeev I, Carpenter KL, Nortje J, et al. Cerebral extracellular chemistry and outcome following traumatic brain injury: a microdialysis study of 223 patients[J]. Brain, 2011, 134(Pt 2): 484-494. DOI: 10.1093/brain/awq353.
[48]	Carney N, Totten AM, O'reilly C, et al. Guidelines for the management of severe traumatic brain injury, fourth edition[J]. Neurosurgery, 2017, 80(1): 6-15. DOI: 10.1227/NEU.0000000000001432.
[49]	Rubinos C, Alkhachroum A, Der-Nigoghossian C, et al. Electroencephalogram monitoring in critical care[J]. Semin Neurol, 2020, 40(6): 675-680. DOI: 10.1055/s-0040-1719073.
[50]	Sandroni C, Skrifvars MB, Taccone FS. Brain monitoring after cardiac arrest[J]. Curr Opin Crit Care, 2023, 29(2): 68-74. DOI: 10.1097/MCC.0000000000001023.
[51]	Barkatullah AF, Leishangthem L, Moss HE. MRI findings as markers of idiopathic intracranial hypertension[J]. Curr Opin Neurol, 2021, 34(1): 75-83. DOI: 10.1097/WCO.0000000000000885.
[52]	Pappu S, Lerma J, Khraishi T. Brain CT to assess intracranial pressure in patients with traumatic brain injury[J]. J Neuroimaging, 2016, 26(1): 37-40. DOI: 10.1111/jon.12289.
[53]	Aiolfi A, Benjamin E, Khor D, et al. Brain trauma foundation guidelines for intracranial pressure monitoring: compliance and effect on outcome[J]. World J Surg, 2017, 41(6): 1543-1549. DOI: 10.1007/s00268-017-3898-6.
[54]	Menon DK, Ercole A. Critical care management of traumatic brain injury[J]. Handb Clin Neurol, 2017, 140: 239-274. DOI: 10.1016/B978-0-444-63600-3.00014-3.
[55]	Foreman B, Lissak I A, Kamireddi N, et al. Challenges and opportunities in multimodal monitoring and Data analytics in traumatic brain injury[J]. Curr Neurol Neurosci Rep, 2021, 21(3): 6. DOI: 10.1007/s11910-021-01098-y.
[56]	Raj R, Luostarinen T, Pursiainen E, et al. Machine learning-based dynamic mortality prediction after traumatic brain injury[J]. Sci Rep, 2019, 9(1): 17672. DOI: 10.1038/s41598-019-53889-6.

监测方法	主要功能	准确性	应用性	感染风险	出血风险	成本消耗	操作难度	参考文献
脑室型ICP	脑室外引流，ICP监测	高	高	高	高	高	中	[8]
TCD	监测脑血流	中	高	低	低	低	高	[20]
ONSD	检查视神经鞘直径大小	中	高	低	低	低	高	[21]
CT/MRI	检查颅内病变	中	高	低	低	低	低	[22]
FVEP	皮层诱发电位	中	中	低	低	低	高	[23]
无创头感颅内压监测仪	ICP监测	中	高	低	低	高	中	[24]
PbtO₂	监测脑氧	中	中	高	中	高	高	[25]
SjvO₂	监测脑氧	低	低	高	中	高	高	[26]
NIRS	监测脑氧	低	低	低	低	高	高	[27]
CMD	监测脑代谢	低	低	中	中	中	高	[28]
cEEG	监测脑电活动	低	低	低	低	中	高	[29]

监测方法	主要功能	准确性	应用性	感染风险	出血风险	成本消耗	操作难度	参考文献
脑室型ICP	脑室外引流，ICP监测	高	高	高	高	高	中	[8]
TCD	监测脑血流	中	高	低	低	低	高	[20]
ONSD	检查视神经鞘直径大小	中	高	低	低	低	高	[21]
CT/MRI	检查颅内病变	中	高	低	低	低	低	[22]
FVEP	皮层诱发电位	中	中	低	低	低	高	[23]
无创头感颅内压监测仪	ICP监测	中	高	低	低	高	中	[24]
PbtO₂	监测脑氧	中	中	高	中	高	高	[25]
SjvO₂	监测脑氧	低	低	高	中	高	高	[26]
NIRS	监测脑氧	低	低	低	低	高	高	[27]
CMD	监测脑代谢	低	低	中	中	中	高	[28]
cEEG	监测脑电活动	低	低	低	低	中	高	[29]

Please choose a citation manager

Content to export