Actualizaciones en los métodos de monitorización cerebral regional en los pacientes neurocríticos: presión tisular de oxígeno, microdiálisis cerebral y técnicas de espectroscopía por infrarrojos
Recent advances in regional cerebral monitoring in the neurocritical patient: brain tissue oxygen pressure monitoring, cerebral microdialysis and near-infrared spectroscopy
M.P. Mena, A. Vilalta
Unidad de Investigación de Neurotraumatología. Hospital Universitario Vall d’Hebron. Universidad Autónoma de Barcelona. Barcelona
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Paseo Vall d’Hebron 119-129. 08035, Barcelona." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Recent advances in regional cerebral monitoring in the neurocritical patient: brain tissue oxygen pressure monitoring, cerebral microdialysis and near-infrared spectroscopy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-01-20" "fechaAceptado" => "2005-02-09" "PalabrasClave" => array:2 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec159020" "palabras" => array:5 [ 0 => "Traumatismos craneoencefálicos" 1 => "Metabolismo cerebral" 2 => "Oxigenación tisular" 3 => "Microdiálisis" 4 => "Espectroscopía por infrarrojos" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abreviaturas" "identificador" => "xpalclavsec159019" "palabras" => array:16 [ 0 => "CEO<span class="elsevierStyleInf">2</span>" 1 => "FSC" 2 => "Hb" 3 => "LCR" 4 => "O<span class="elsevierStyleInf">2</span>" 5 => "PaO<span class="elsevierStyleInf">2</span>" 6 => "PaCO<span class="elsevierStyleInf">2</span>" 7 => "PIC" 8 => "PPC" 9 => "PtiO<span class="elsevierStyleInf">2</span>" 10 => "SjO<span class="elsevierStyleInf">2</span>" 11 => "SPECT" 12 => "TC" 13 => "TCDB" 14 => "TCE" 15 => "UCI" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec159018" "palabras" => array:5 [ 0 => "Head injury" 1 => "Brain metabolism" 2 => "Tissular oxygenation" 3 => "Microdialysis" 4 => "Near-infrared spectroscopy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El resultado final de los pacientes que han presentado un traumatismo craneoencefálico (TCE) depende de las lesiones primarias, pero también, y en gran medida, de las lesiones secundarias. El diagnóstico de un gran número de lesiones secundarias, y en especial de la isquemia cerebral, se centra en la monitorización simultánea de diversas variables encefálicas y sistémicas. En el momento actual, la monitorización continua de la presión intracraneal (PIC) se considera una medida indispensable en el manejo de los pacientes con un TCE grave que presentan cualquier tipo de lesión intracraneal. Sin embargo, la información que ofrece esta variable es insuficiente para diagnosticar los complejos procesos fisiopatológicos que caracterizan a las lesiones neurotraumáticas. Por ello, cada vez es más frecuente complementar la neuromonitorización de los pacientes con un TCE con métodos de estimación del flujo sanguíneo cerebral (FSC) como el Doppler transcraneal o las técnicas de oximetría yugular. Sin embargo, en el momento actual y en la cabecera del paciente, el conocimiento de la repercusión de las lesiones tisulares y de las medidas terapéuticas sobre el metabolismo cerebral requiere un acceso directo al parénquima encefálico. En esta revisión nos centraremos en tres métodos de monitorización cerebral “regional”: la presión tisular de oxígeno, la microdiálisis cerebral y las técnicas transcutáneas de espectroscopía por infrarrojos. En cada caso se expondrán los fundamentos del método en cuestión, los valores de referencia de los parámetros monitorizados y una serie de recomendaciones sobre cómo pueden interpretarse sus resultados a la luz de los conocimientos actuales.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The long term outcome of head-injured patients depends not only on the primary brain lesions but also to a large extent on the secondary lesions. The diagnosis of many secondary lesions, and specially that of brain ischemia, is based on simultaneous monitoring of several intracranial and systemic variables. Continuous intracranial pressure (ICP) monitoring is currently considered indispensable in the management of all patients with a severe head injury and intracranial lesions. However, the information provided by this technique is insufficient to diagnose some of the complex physiopathological processes that characterize traumatic brain lesions. Consequently, the use of methods to estimate cerebral blood flow such as transcranial Doppler and jugular oximetry to complement ICP monitoring is becoming increasingly widespread. Nevertheless, determining the effect of tissue lesions and therapeutic measures on cerebral metabolism currently requires direct access to the brain parenchyma at the bedside. In this review we focus on three methods of regional cerebral monitoring: oxygen tissue pressure (PtiO<span class="elsevierStyleInf">2</span>) monitoring, microdialysis and near-infrared spectroscopy. The bases of each method and reference values for the variables analyzed will be discussed. We also make a series of recommendations on how results should be interpreted in light of current knowledge.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Poca, M.A.; Sahuquillo, J.; Mena, M.P.; Vilalta, A.; Riveiro, M.: Actualizaciones en los métodos de monitorización cerebral regional en los pacientes neurocríticos: presión tisular de oxígeno, microdiálisis cerebral y técnicas de espectroscopía por infrarrojos. Neurocirugía 2005; 16: 385–410.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:103 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.S. Ali" 1 => "M. Harmer" 2 => "R.S. Vaughan" 3 => "J.A. Dunne" 4 => "I.P. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Abril | 0 | 1 | 1 |
| 2023 Marzo | 2 | 1 | 3 |
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| 2018 Enero | 32 | 10 | 42 |
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| 2017 Junio | 31 | 32 | 63 |
| 2017 Mayo | 24 | 31 | 55 |
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| 2017 Marzo | 13 | 33 | 46 |
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| 2017 Enero | 16 | 31 | 47 |
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