Effect of a temporary lying position on cerebral hemodynamic and cerebral oxygenation parameters in patients with severe brain trauma

Dagod, Geoffrey; Roustan, Jean‐Paul; Bringuier-Branchereau, Sophie; Ridolfo, Jérôme; Martinez, Orianne; Capdevila, Xavier; Charbit, Jonathan

doi:10.1007/s00701-021-04851-x

Cited by 7 publications

(7 citation statements)

References 39 publications

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“…Cerebral T, cerebral temperature; CMD, cerebral microdialysis; dEEG, depth electroencephalography; ECoG, electrocorticography; ICP, intracranial pressure; NIRS, near-infrared spectroscopy; PbtO 2 , partial pressure of brain tissue oxygenation; rCBF, regional cerebral blood flow; sEEG, surface electroencephalography; SvjO 2 , jugular bulb venous oximetry; TCD, transcranial Doppler. (Lubillo et al, 2018) or monitoring the effectiveness of an intervention in both the MMM signals and clinical outcome (8 studies) (Hockel et al, 2016;Jakkula et al, 2018;Ding et al, 2019;Sekhon et al, 2019;Svedung Wettervik et al, 2020b;Dagod et al, 2021;Kovacs et al, 2021). For MMM-guided intervention studies, clinical outcome resulted from the interplay between MMM and interventions.…”

Section: Results Objective Iii: Interventions Potential Therapiesmentioning

confidence: 99%

“…Clinical outcome is a study endpoint in 18 (41%) of the 44 interventional studies. Systemic- and cerebral interventions evaluated MMM for either outcome prediction (1 study) ( Lubillo et al, 2018 ) or monitoring the effectiveness of an intervention in both the MMM signals and clinical outcome (8 studies) ( Hockel et al, 2016 ; Jakkula et al, 2018 ; Ding et al, 2019 ; Sekhon et al, 2019 ; Svedung Wettervik et al, 2020b ; Dagod et al, 2021 ; Kovacs et al, 2021 ). For MMM-guided intervention studies, clinical outcome resulted from the interplay between MMM and interventions.…”

Section: Results Objective Iii: Clinical Outcome In Interventional St...mentioning

confidence: 99%

“…Intrahospital transport, head elevation/flat position 3 (Burnol et al, 2021;Dagod et al, 2021;Hosmann et al, 2021) Vasospasm therapy Nimodipine, endovascular therapy, papaverinehydrochloride 4 ( Hockel et al, 2016;Albanna et al, 2017;Hockel et al, 2017;Hosmann et al, 2020) Ventilation management Hyperoxia, hypercapnia, hypocapnia 10 ( Westermaier et al, 2016;Zhang et al, 2016;Ghosh et al, 2017;Sahoo et al, 2017;Brandi et al, 2019;Calviello et al, 2019;Svedung Wettervik et al, 2020b;Stetter et al, 2021;Gargadennec et al, 2022;Hosmann et al, 2022) b Other therapies Analgesia, hypothermia, enteral nutrition, decompressive craniectomy 4 ( Flynn et al, 2015;Kofler et al, 2018;Kovac et al, 2018;Ianosi et al, 2020) a One study included both cerebral intervention and MMM-guided treatment (mixed interventions Frontiers in Physiology frontiersin.org (Svedung Wettervik et al, 2019;Svedung Wettervik et al, 2020b;Svedung Wettervik et al, 2020a). The strength of a recycled study cohort is that it saves time and money; and could result in a broad understanding of the neuromonitoring signals.…”

Section: Physical (Movement) Interventionsmentioning

confidence: 99%

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Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: A narrative review

et al. 2022

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Cerebral multimodality monitoring (MMM) is, even with a general lack of Class I evidence, increasingly recognized as a tool to support clinical decision-making in the neuroscience intensive care unit (NICU). However, literature and guidelines have focused on unimodal signals in a specific form of acute brain injury. Integrating unimodal signals in multiple signal monitoring is the next step for clinical studies and patient care. As such, we aimed to investigate the recent application of MMM in studies of adult patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), acute ischemic stroke (AIS), and hypoxic ischemic brain injury following cardiac arrest (HIBI). We identified continuous or daily updated monitoring modalities and summarized the monitoring setting, study setting, and clinical characteristics. In addition, we discussed clinical outcome in intervention studies. We identified 112 MMM studies, including 11 modalities, over the last 7 years (2015–2022). Fifty-eight studies (52%) applied only two modalities. Most frequently combined were ICP monitoring (92 studies (82%)) together with PbtO2 (63 studies (56%). Most studies included patients with TBI (59 studies) or SAH (53 studies). The enrollment period of 34 studies (30%) took more than 5 years, whereas the median sample size was only 36 patients (q1- q3, 20–74). We classified studies as either observational (68 studies) or interventional (44 studies). The interventions were subclassified as systemic (24 studies), cerebral (10 studies), and interventions guided by MMM (11 studies). We identified 20 different systemic or cerebral interventions. Nine (9/11, 82%) of the MMM-guided studies included clinical outcome as an endpoint. In 78% (7/9) of these MMM-guided intervention studies, a significant improvement in outcome was demonstrated in favor of interventions guided by MMM. Clinical outcome may be improved with interventions guided by MMM. This strengthens the belief in this application, but further interdisciplinary collaborations are needed to overcome the heterogeneity, as illustrated in the present review. Future research should focus on increasing sample sizes, improved data collection, refining definitions of secondary injuries, and standardized interventions. Only then can we proceed with complex outcome studies with MMM-guided treatment.

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Section: Results Objective Iii: Interventions Potential Therapiesmentioning

confidence: 99%

Section: Results Objective Iii: Clinical Outcome In Interventional St...mentioning

confidence: 99%

Section: Physical (Movement) Interventionsmentioning

confidence: 99%

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Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: A narrative review

et al. 2022

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“…Therefore, patients with moderate to severe TBI frequently exhibit cognitive and motor impairments, which severely impact their quality of life. The prevalence of disability post-TBI is stratified by severity, with rates of 10%, 66%, and 100% for mild, moderate, and severe cases, respectively [ 4 ]. Earlier admission to post-injury rehabilitation is associated with better functional outcomes in acute care [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial

Yen,

Chuang,

Hsiao

et al. 2024

Crit Care

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Introduction Traumatic brain injury (TBI) is a major cause of neurodisability worldwide, with notably high disability rates among moderately severe TBI cases. Extensive previous research emphasizes the critical need for early initiation of rehabilitation interventions for these cases. However, the optimal timing and methodology of early mobilization in TBI remain to be conclusively determined. Therefore, we explored the impact of early progressive mobilization (EPM) protocols on the functional outcomes of ICU-admitted patients with moderate to severe TBI. Methods This randomized controlled trial was conducted at a trauma ICU of a medical center; 65 patients were randomly assigned to either the EPM group or the early progressive upright positioning (EPUP) group. The EPM group received early out-of-bed mobilization therapy within seven days after injury, while the EPUP group underwent early in-bed upright position rehabilitation. The primary outcome was the Perme ICU Mobility Score and secondary outcomes included Functional Independence Measure motor domain (FIM-motor) score, phase angle (PhA), skeletal muscle index (SMI), the length of stay in the intensive care unit (ICU), and duration of ventilation. Results Among 65 randomized patients, 33 were assigned to EPM and 32 to EPUP group. The EPM group significantly outperformed the EPUP group in the Perme ICU Mobility and FIM-motor scores, with a notably shorter ICU stay by 5.9 days (p < 0.001) and ventilation duration by 6.7 days (p = 0.001). However, no significant differences were observed in PhAs. Conclusion The early progressive out-of-bed mobilization protocol can enhance mobility and functional outcomes and shorten ICU stay and ventilation duration of patients with moderate-to-severe TBI. Our study’s results support further investigation of EPM through larger, randomized clinical trials. Clinical trial registration ClinicalTrials.gov NCT04810273. Registered 13 March 2021.

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“…The fatality rate of mild, moderate, and severe TBI is 0.7%, 26% and 58%, respectively. The disability rate is 10%, 66%, and 100%, respectively [ 4 ]. The main causes of TBI include traffic accidents, industrial accidents, accidental falls, sports injuries, falls, dystocia, and surgical delivery.…”

Section: Introductionmentioning

confidence: 99%

Effect of Early Rehabilitation Nursing on Motor Function and Living Ability of Patients with Traumatic Brain Injury Based on Orem’s Self-Care Theory

Yang

Niu

2022

Computational Intelligence and Neuroscience

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Objective. To explore the effect of early rehabilitation nursing on motor function and living ability of patients with traumatic brain injury (TBI) based on Orem’s self-care theory. Methods. A total of 60 patients with TBI treated in our hospital from February 2019 to June 2021 were enrolled. The patients were randomly divided into a control group and a research group. The control group adopted the early rehabilitation nursing model, while the research group adopted the early rehabilitation nursing model based on Orem’s self-nursing theory. Nursing satisfaction, Fugl-Meyer score, NIH-SS score, Barthel index, quality of life score, and compliance were in the comparison of the two groups. Results. The nursing satisfaction of the research group was higher than that of the control group ( P < 0.05). Compared with the control group, the Fugl-Meyer scores of the research group were higher at 1 month, 2 months, and 3 months after nursing ( P < 0.05). After nursing, the NIH-SS score of the two groups decreased. In the comparison of the two groups, the NIH-SS score of the research group at 1 month, 2 months, and 3 months after nursing was lower ( P < 0.05). After nursing, the Barthel index of the two groups increased. In the comparison of the two groups, the Barthel index of the research group was higher compared to the control group at 1 month, 2 months, and 3 months after nursing ( P < 0.05). The scores of physiological function, psychological function, social function, and health self-cognition in the research group were lower ( P < 0.05). The compliance rate of the research group was higher than that of the control group ( P < 0.05). Conclusion. Patients with TBI receive early rehabilitation nursing based on Orem’s self-care theory, which can effectively improve patient satisfaction and compliance and achieve the purpose of improving motor function and living ability. This nursing program is worth popularizing in the clinic.

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Effect of a temporary lying position on cerebral hemodynamic and cerebral oxygenation parameters in patients with severe brain trauma

Cited by 7 publications

References 39 publications

Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: A narrative review

Cerebral multimodality monitoring in adult neurocritical care patients with acute brain injury: A narrative review

Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial

Effect of Early Rehabilitation Nursing on Motor Function and Living Ability of Patients with Traumatic Brain Injury Based on Orem’s Self-Care Theory

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