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OasisLMS
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Neurocritical Care Review Course
Cerebral Hemodynamic Monitoring
Cerebral Hemodynamic Monitoring
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Video Transcription
Video Summary
In this video, Aarti Sarwal provides a fast-paced review of cerebral hemodynamic monitoring. She covers various physiological concepts such as intracranial pressure (ICP), cerebral perfusion pressure (CPP), and compliance. Sarwal discusses different neuromonitoring techniques used to evaluate hemodynamic parameters including ICP, blood flow, and oxygenation. She emphasizes the importance of monitoring patients who may not be able to undergo clinical examination, such as comatose or sedated patients. Sarwal explains the Monroe Kelly doctrine, which describes the relationship between brain, blood, and cerebrospinal fluid (CSF) within the skull. She discusses the purpose of measuring cerebral hemodynamics, which is to identify salvageable tissue from the lost tissue, although there is no single test that can provide a definitive answer. Various monitoring methods for ICP, such as external ventricular drainage catheters and fiber optic strain gauge monitors, are explained. Sarwal also discusses the targets for therapy, including ICP, CPP, and auto-regulation, and the challenges associated with determining optimal thresholds. She mentions different clinical algorithms and protocols, as well as management strategies for ICP control, including optimizing ABCs, osmotic therapy, sedation, and surgical decompression. The importance of multi-modality monitoring, including measuring cerebral blood flow and other physiological variables, is highlighted. Sarwal concludes by mentioning ongoing and future research trials in the field of cerebral hemodynamic monitoring.
Asset Caption
Aarti Sarwal, MD, FAAN, FNCS, FCCM
Keywords
cerebral hemodynamic monitoring
intracranial pressure
cerebral perfusion pressure
compliance
neuromonitoring techniques
Monroe Kelly doctrine
cerebral blood flow
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