Citation

Denchev K, Gomez J, Chen P, Rosenblatt K. Anesthesiol. Clin. 2023; 41(1): 39-78.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.anclin.2022.11.003

PMID

36872007

Abstract

Traumatic brain injury is a devastating event associated with substantial morbidity. Pathophysiology involves the initial trauma, subsequent inflammatory response, and secondary insults, which worsen brain injury severity. Management entails cardiopulmonary stabilization and diagnostic imaging with targeted interventions, such as decompressive hemicraniectomy, intracranial monitors or drains, and pharmacological agents to reduce intracranial pressure. Anesthesia and intensive care requires control of multiple physiologic variables and evidence-based practices to reduce secondary brain injury. Advances in biomedical engineering have enhanced assessments of cerebral oxygenation, pressure, metabolism, blood flow, and autoregulation. Many centers employ multimodality neuromonitoring for targeted therapies with the hope to improve recovery.

Language: en

Keywords

Traumatic brain injury; Brain tissue oxygen monitoring; Cerebral autoregulation; Cerebral microdialysis; Intracranial pressure; Multimodality neuromonitoring; Near-infrared spectroscopy; Transcranial doppler