Medical engineering & physics
-
Integration of various brain signals can be used to determine cerebral autoregulation in neurocritical care patients to guide clinical management and to predict outcome. In this review, we will discuss current methodology of multimodal brain monitoring focusing on secondary 'reactivity indices' derived from various brain signals which are based on a 'moving correlation coefficient'. ⋯ Of the various primary neuromonitoring sources which can be used to calculate reactivity indices, we will focus in this review on indices based on transcranial Doppler (TCD), intracranial pressure (ICP), brain tissue oxygenation (PbtO2) and near infrared spectroscopy (NIRS). Furthermore, we will demonstrate how reactivity indices can show transient changes of cerebral autoregulation and can be used to optimize management of arterial blood pressure (ABP) and cerebral perfusion pressure (CPP).