From: The Importance of Neuromonitoring in Non Brain Injured Patients
Setting | Neurological complications | Neuromonitoring | Evidence |
---|---|---|---|
Cardiac arrest | Neurological outcome | EEG or pEEG | Prognostication after cardiac arrest |
Evoked potentials | Prognostication after cardiac arrest (SSEPs) after 48–72 h | ||
TCD | Detection of CBF abnormalities and intracranial hypertension | ||
Pupillometry | Prognostication after cardiac arrest | ||
Brain death | Diagnosis | EEG or pEGG | Electrocerebral silence |
TCD | Detection of flow inversion, intracranial hypertension. Ancillary test | ||
Pupillometry | No response | ||
ECMO | Neurological outcome | EEG or pEGG | Prognostication in patients receiving ECMO |
TCD | CBF alterations, stroke | ||
NIRS | Association with neurological injury | ||
ARDS and COVID-19 ARDS | Neurological complications, delirium | EEG or pEGG | Typical EEG includes abnormal background, epileptiform discharges in only 20% |
TCD | Pulmonary shunt, microemboli, CBF alterations, cerebral autoregulation | ||
NIRS | To detect brain deoxygenation, and responses to hemodynamic and respiratory maneuvers | ||
Pupillometry | Inconclusive evidence | ||
Liver diseases | Encephalopathy | TCD | High resistances on TCD, CBF alterations |
NIRS | Association with outcome | ||
Pupillometry | Pupillary abnormalities are associated with neurological complications | ||
Kidney disease | Encephalopathy | TCD | CBF alterations |
NIRS | Association with outcome | ||
Sepsis | Encephalopathy | TCD | High resistances on TCD, altered CBF, high PI. Association between PI and delirium |
NIRS | Association with outcome | ||
Pupillometry | Pupillary abnormalities are associated with neurological complications |