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Published on: March 26, 2019
The State of the Field of Pediatric Multimodality Neuromonitoring
Jennifer C Erklauer1, Yi-Chen Lai2
1Divisions of Critical Care Medicine and Pediatric Neurology and Developmental Neurosciences, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA. jclee@bcm.edu.
Insights
Multimodal neuromonitoring, combining data from various devices, is emerging in pediatric neurocritical care. Further research is needed to establish best practices and optimize outcomes for critically ill children.
Area of Science:
- Neuroscience
- Pediatric Critical Care
Background:
- Pediatric neurocritical care is nascent compared to adult care.
- Multimodal neuromonitoring integrates data from multiple devices for a holistic brain assessment.
- It enables adaptive, individualized therapies for evolving brain injury states.
Purpose of the Study:
- To provide an overview of multimodal neuromonitoring in pediatric neurocritical care.
- To discuss its future applications and potential benefits.
Main Methods:
- Overview of multimodal neuromonitoring principles and devices.
- Discussion of clinical implementation challenges and strategies in pediatrics.
Main Results:
- Multimodal neuromonitoring aids in data trend visualization and pattern recognition.
- Clinical application in pediatrics requires further study to define best practices and patient outcomes.
- Potential uses include guiding physiological targets, neuroprotection, and neuroprognostication.
- Successful implementation necessitates interprofessional collaboration and comprehensive support programs.
Conclusions:
- Multimodal neuromonitoring offers significant potential benefits for advancing pediatric neurocritical care.
- It holds promise for improving the health outcomes of critically ill children.
Background:
The use of multimodal neuromonitoring in pediatrics is in its infancy relative to adult neurocritical care. Multimodal neuromonitoring encompasses the amalgamation of information from multiple individual neuromonitoring devices to gain a more comprehensive understanding of the condition of the brain. It allows for adaptation to the changing state of the brain throughout various stages of injury with potential to individualize and optimize therapies.
Methods:
Here we provide an overview of multimodal neuromonitoring in pediatric neurocritical care and its potential application in the future.
Results:
Multimodal neuromonitoring devices are key to the process of multimodal neuromonitoring, allowing for visualization of data trends over time and ideally improving the ability of clinicians to identify patterns and find meaning in the immense volume of data now encountered in the care of critically ill patients at the bedside. Clinical use in pediatrics requires more study to determine best practices and impact on patient outcomes. Potential uses include guidance for targets of physiological parameters in the setting of acute brain injury, neuroprotection for patients at high risk for brain injury, and neuroprognostication. Implementing multimodal neuromonitoring in pediatric patients involves interprofessional collaboration with the development of a simultaneous comprehensive program to support the use of multimodal neuromonitoring while maintaining the fundamental principles of the delivery of neurocritical care at the bedside.
Conclusions:
The possible benefits of multimodal neuromonitoring are immense and have great potential to advance the field of pediatric neurocritical care and the health of critically ill children.
