Abstract
Secondary brain injury results from ischemia, tissue hypoxia, and a cascade of ongoing metabolic events. Neuromonitoring has evolved over the last two decades with the goal of preventing, detecting, and attenuating the damage from these secondary events. Typical monitored parameters include intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Advanced multimodal monitoring includes monitoring of cerebral blood flow (CBF), brain tissue oxygenation (transcranial oximetry, jugular bulb oximetry, brain tissue oxygen tension), and brain metabolism (intracerebral microdialysis). In this chapter, we will review basic principles of brain physiology and the complex and dynamic interactions between these parameters. In the future, neuromonitoring will be supported by advanced signal processing and analysis that will enable clinicians to synthesize information and form hypotheses that best explain the current situation. Such an integrated system will translate data into actionable information and provide situational awareness.
