PDF(Pubmed)
Abstract：
Severe acute brain injuries, stemming from trauma, ischemia or hemorrhage, remain a significant global healthcare concern due to their association with high morbidity and mortality rates. Accurate assessment of secondary brain injuries severity is pivotal for tailor adequate therapies in such patients. Together with neurological examination and brain imaging, monitoring of systemic secondary brain injuries is relatively straightforward and should be implemented in all patients, according to local resources. Cerebral secondary injuries involve factors like brain compliance loss, tissue hypoxia, seizures, metabolic disturbances and neuroinflammation. In this viewpoint, we have considered the combination of specific noninvasive and invasive monitoring tools to better understand the mechanisms behind the occurrence of these events and enhance treatment customization, such as intracranial pressure monitoring, brain oxygenation assessment and metabolic monitoring. These tools enable precise intervention, contributing to improved care quality for severe brain injury patients. The future entails more sophisticated technologies, necessitating knowledge, interdisciplinary collaboration and resource allocation, with a focus on patient-centered care and rigorous validation through clinical trials.
摘要：
严重的急性脑损伤,源于创伤，缺血或出血，由于它们与高发病率和死亡率相关，仍然是一个重要的全球医疗保健问题。准确评估继发性脑损伤的严重程度对于为此类患者量身定制适当的治疗方法至关重要。连同神经系统检查和脑成像,全身继发性脑损伤的监测相对简单，应该在所有患者中实施，根据当地资源。脑继发性损伤涉及脑顺应性丧失等因素，组织缺氧，癫痫发作,代谢紊乱和神经炎症。在这个观点中,我们考虑了特定的非侵入性和侵入性监测工具的组合，以更好地了解这些事件发生背后的机制并增强治疗定制，比如颅内压监测,脑氧合评估和代谢监测。这些工具可以实现精确干预，有助于改善严重脑损伤患者的护理质量。未来需要更复杂的技术，需要知识，跨学科合作和资源分配，专注于以患者为中心的护理，并通过临床试验进行严格的验证。
