无创多模式神经监测在新冠肺炎感染成人危重症患者中的应用。

IF 2.3 2区 医学 Q2 ANESTHESIOLOGY
Denise Battaglini, Lavienraj Premraj, Samuel Huth, Jonathon Fanning, Glenn Whitman, Rakesh C Arora, Judith Bellapart, Diego Bastos Porto, Fabio S Taccone, Jacky Y Suen, Gianluigi Li Bassi, John F Fraser, Sung-Min Cho, Chiara Robba
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引用次数: 3

摘要

简介:对于入住重症监护室(ICU)的2019冠状病毒病(新冠肺炎)患者的脑功能障碍,无创神经监测可能是一种有价值的床边评估选择。本系统综述旨在研究无创多模式神经监测在新冠肺炎感染的成年危重患者中的应用。方法:检索MEDLINE/PubMed、Scopus、Cochrane和EMBASE数据库,研究入住ICU的新冠肺炎患者的无创神经监测。监测包括经颅多普勒超声(TCD)、Brain4care Corp.大脑顺应性监测仪(B4C)、视神经鞘直径(ONSD)、近红外光谱、自动瞳孔测量、,结果:通过对7001篇文章的系统检索,确定了32项研究新冠肺炎患者在ICU中的无创神经监测技术:1项研究研究TCD、ONSD和瞳孔测量;2项研究B4C装置和TCD;研究近红外光谱和中药的3项研究;4项TCD研究;1个研究瞳孔测量的病例系列和21项研究脑电图。119名患者接受了TCD监测、47次瞳孔测量、49次ONSD评估、50次B4C设备依从性监测和900次脑电图监测。在入住ICU的新冠肺炎患者中,脑血流动力学、脑顺应性、脑氧合、瞳孔反应和脑电生理活动的改变是常见的;这些异常与更糟糕的结果或新的神经系统并发症的发展没有明确的关联。结论:在危重新冠肺炎患者中使用无创多模式神经监测可被认为有助于检测神经紊乱。确定这些发现是否可以更早地发现神经系统并发症或指导适当的治疗需要额外的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Use of Noninvasive Multimodal Neuromonitoring in Adult Critically Ill Patients With COVID-19 Infection.

Introduction: Noninvasive neuromonitoring could be a valuable option for bedside assessment of cerebral dysfunction in patients with coronavirus disease-2019 (COVID-19) admitted to intensive care units (ICUs). This systematic review aims to investigate the use of noninvasive multimodal neuromonitoring in critically ill adult patients with COVID-19 infection.

Methods: MEDLINE/PubMed, Scopus, Cochrane, and EMBASE databases were searched for studies investigating noninvasive neuromonitoring in patients with COVID-19 admitted to ICUs. The monitoring included transcranial Doppler ultrasonography (TCD), the Brain4care Corp. cerebral compliance monitor (B4C), optic nerve sheath diameter (ONSD), near infrared spectroscopy, automated pupillometry, and electroencephalography (EEG).

Results: Thirty-two studies that investigated noninvasive neuromonitoring techniques in patients with COVID-19 in the ICU were identified from a systematic search of 7001 articles: 1 study investigating TCD, ONSD and pupillometry; 2 studies investigating the B4C device and TCD; 3 studies investigating near infrared spectroscopy and TCD; 4 studies investigating TCD; 1 case series investigating pupillometry, and 21 studies investigating EEG. One hundred and nineteen patients underwent TCD monitoring, 47 pupillometry, 49 ONSD assessment, 50 compliance monitoring with the B4C device, and 900 EEG monitoring. Alterations in cerebral hemodynamics, brain compliance, brain oxygenation, pupillary response, and brain electrophysiological activity were common in patients with COVID-19 admitted to the ICU; these abnormalities were not clearly associated with worse outcome or the development of new neurological complications.

Conclusions: The use of noninvasive multimodal neuromonitoring in critically ill COVID-19 patients could be considered to facilitate the detection of neurological derangements. Determining whether such findings allow earlier detection of neurological complications or guide appropriate therapy requires additional studies.

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来源期刊
CiteScore
6.20
自引率
10.80%
发文量
119
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Anesthesiology (JNA) is a peer-reviewed publication directed to an audience of neuroanesthesiologists, neurosurgeons, neurosurgical monitoring specialists, neurosurgical support staff, and Neurosurgical Intensive Care Unit personnel. The journal publishes original peer-reviewed studies in the form of Clinical Investigations, Laboratory Investigations, Clinical Reports, Review Articles, Journal Club synopses of current literature from related journals, presentation of Points of View on controversial issues, Book Reviews, Correspondence, and Abstracts from affiliated neuroanesthesiology societies. JNA is the Official Journal of the Society for Neuroscience in Anesthesiology and Critical Care, the Neuroanaesthesia and Critical Care Society of Great Britain and Ireland, the Association de Neuro-Anesthésiologie Réanimation de langue Française, the Wissenschaftlicher Arbeitskreis Neuroanästhesie der Deutschen Gesellschaft fur Anästhesiologie und Intensivmedizen, the Arbeitsgemeinschaft Deutschsprachiger Neuroanästhesisten und Neuro-Intensivmediziner, the Korean Society of Neuroanesthesia, the Japanese Society of Neuroanesthesia and Critical Care, the Neuroanesthesiology Chapter of the Colegio Mexicano de Anesthesiología, the Indian Society of Neuroanesthesiology and Critical Care, and the Thai Society for Neuroanesthesia.
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