Abstract：
Acute neurologic injury is common in critically ill children. Some conditions - such as traumatic brain injury, meningitis, and hypoxic-ischemic injury following cardiac arrest - require careful consideration of cerebral physiology. Specialized neuromonitoring techniques provide insight regarding patient-specific and disease-specific insight that can improve diagnostic accuracy, aid in targeting therapeutic interventions, and provide prognostic information. In this review, we will discuss recent innovations in invasive (e.g., intracranial pressure monitoring and related computed indices) and noninvasive (e.g., transcranial doppler, near-infrared spectroscopy) neuromonitoring techniques used in traumatic brain injury, central nervous system infections, and after cardiac arrest. We will discuss the pertinent physiological mechanisms interrogated by each technique and discuss available evidence for potential clinical application. We will also discuss the use of innovative neuromonitoring techniques to detect and manage neurologic complications in critically ill children with systemic illness, focusing on sepsis and cardiorespiratory failure requiring extracorporeal membrane oxygenation.
摘要：
急性神经损伤常见于危重患儿。一些情况——比如创伤性脑损伤，脑膜炎,和心脏骤停后的缺氧缺血性损伤-需要仔细考虑脑生理学。专门的神经监测技术提供有关患者特定和疾病特定的见解，可以提高诊断准确性，帮助瞄准治疗干预措施，并提供预后信息。在这次审查中,我们将讨论最近在侵入性方面的创新(例如，颅内压监测和相关计算指标)和非侵入性(例如，经颅多普勒,近红外光谱）用于创伤性脑损伤的神经监测技术，中枢神经系统感染,在心脏骤停之后.我们将讨论每种技术所询问的相关生理机制，并讨论潜在临床应用的可用证据。我们还将讨论使用创新的神经监测技术来检测和管理患有系统性疾病的危重患儿的神经系统并发症，专注于需要体外膜氧合的败血症和心肺功能衰竭。
