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Practice Standards for the Use of Multimodality Neuromonitoring: A Delphi Consensus Process.
Brandon Foreman1, Gregory Kapinos2, Mark S Wainwright3
1Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH.
Critical Care Medicine
|August 22, 2023
Summary
Multimodality neuromonitoring (MNM) consensus was reached on its use in coma patients with TBI and hemorrhage. Experts agreed on necessary technologies, skills, and training for effective MNM integration and interpretation in critical care.
Area of Science:
- Neuroscience
- Critical Care Medicine
- Medical Technology
Background:
- Multimodality neuromonitoring (MNM) integrates data from various sources to assess brain health.
- Lack of consensus exists regarding optimal technologies, effort, and training for MNM interpretation.
- Standardizing MNM practices is crucial for improving patient outcomes in intensive care settings.
Purpose of the Study:
- To establish expert consensus on the technologies, effort, and training required for multimodality neuromonitoring (MNM).
- To define practice standards for integrating and interpreting MNM data to individualize patient care.
Main Methods:
- A three-round Delphi consensus process involving 35 experts in adult and pediatric intensive care.
- Utilized electronic surveys and virtual meetings to achieve consensus on MNM-related statements.
- Resolved areas of disagreement through virtual discussions and a final survey.
Main Results:
- Consensus was achieved on 49% of statements regarding MNM.
- Experts agreed on the utility of MNM for patients in coma with traumatic brain injury, aneurysmal subarachnoid hemorrhage, and intracranial hemorrhage.
- Consensus was reached that MNM integration and interpretation require dedicated time, specific skills, and formal training.
Conclusions:
- Expert consensus provides standards for clinical considerations, technologies, implementation, and training for MNM.
- These standards aim to guide the use of MNM for individualized patient care in critical settings.
- The findings highlight the need for structured educational platforms to develop expertise in MNM.
