How to monitor the brain in COVID-19 patients?

Peluso, Lorenzo; Minini, Andrea; Taccone, Fabio Silvio

doi:10.1016/j.iccn.2020.103011

Cited by 5 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Non-invasive multimodal neuromonitoring allows the detection of cerebral derangements at the patient's bedside, and its utility has been recognized both in patients with brain damage and those without primary brain injury ( 8 , 9 ). The most frequently used neuromonitoring techniques to monitor the brain include transcranial doppler (TCD), optic nerve sheath diameter (ONSD), automated pupillometry, near-infrared spectroscopy (NIRS), and electroencephalography (EEG) ( 4 – 6 ).…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

IntroductionNeurological complications are frequent in patients with coronavirus disease-2019 (COVID-19). The use of non-invasive neuromonitoring in subjects without primary brain injury but with potential neurological derangement is gaining attention outside the intensive care unit (ICU). This systematic review and meta-analysis investigates the use of non-invasive multimodal neuromonitoring of the brain in non-critically ill patients with COVID-19 outside the ICU and quantifies the prevalence of abnormal neuromonitoring findings in this population.MethodsA structured literature search was performed in MEDLINE/PubMed, Scopus, Cochrane, and EMBASE to investigate the use of non-invasive neuromonitoring tools, including transcranial doppler (TCD); optic nerve sheath diameter (ONSD); near-infrared spectroscopy (NIRS); pupillometry; and electroencephalography (EEG) inpatients with COVID-19 outside the ICU. The proportion of non-ICU patients with CVOID-19 and a particular neurological feature at neuromonitoring at the study time was defined as prevalence.ResultsA total of 6,593 records were identified through literature searching. Twenty-one studies were finally selected, comprising 368 non-ICU patients, of whom 97 were considered for the prevalence of meta-analysis. The pooled prevalence of electroencephalographic seizures, periodic and rhythmic patterns, slow background abnormalities, and abnormal background on EEG was.17 (95% CI 0.04–0.29), 0.42 (95% CI 0.01–0.82), 0.92 (95% CI 0.83–1.01), and.95 (95% CI 0.088–1.09), respectively. No studies investigating NIRS and ONSD outside the ICU were found. The pooled prevalence for abnormal neuromonitoring findings detected using the TCD and pupillometry were incomputable due to insufficient data.ConclusionsNeuromonitoring tools are non-invasive, less expensive, safe, and bedside available tools with a great potential for both diagnosis and monitoring of patients with COVID-19 at risk of brain derangements. However, extensive literature searching reveals that they are rarely used outside critical care settings.Systematic Review Registration:www.crd.york.ac.uk/prospero/display_record.php?RecordID=265617, identifier: CRD42021265617.

show abstract

Section: Introductionmentioning

confidence: 99%

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…diagnosing the neurological complications of COVID-19, but it may be time consuming, is often difficult and potentially unsafe in unstable critically ill patients, and may pose a risk of viral transmission during transfer. 3 For all these reasons, bedside techniques to assess the brain have undeniable pragmatic advantages in a pandemic situation.…”

mentioning

confidence: 99%

“…Noninvasive neuromonitoring may detect neurological abnormalities at the bedside in patients with COVID-19. 3 Several techniques have been used in this patient population, including transcranial Doppler ultrasonography (TCD), optic nerve sheath diameter (ONSD), Brain4Care Corporation cerebral compliance monitor (B4C), automated pupillometry, near infrared spectroscopy (NIRS) and electroencephalography (EEG). 1,4,5 Each monitoring tool has specific advantages.…”

mentioning

confidence: 99%

“…Diagnosis of these complications is often delayed because patients with severe COVID-19 disease may require deep sedation and the use of neuromuscular blockade to facilitate mechanical ventilation; therefore, accurate neurological evaluations are rarely feasible. Brain imaging may have a role in minimizing the delay in diagnosing the neurological complications of COVID-19, but it may be time consuming, is often difficult and potentially unsafe in unstable critically ill patients, and may pose a risk of viral transmission during transfer 3 . For all these reasons, bedside techniques to assess the brain have undeniable pragmatic advantages in a pandemic situation.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The Use of Noninvasive Multimodal Neuromonitoring in Adult Critically Ill Patients With COVID-19 Infection

Battaglini

Premraj

Huth

et al. 2022

Journal of Neurosurgical Anesthesiology

View full text Add to dashboard Cite

Introduction: Noninvasive neuromonitoring could be a valuable option for bedside assessment of cerebral dysfunction in patients with coronavirus disease-2019 (COVID-19) admitted to intensive care units (ICUs). This systematic review aims to investigate the use of noninvasive multimodal neuromonitoring in critically ill adult patients with COVID-19 infection.Methods: MEDLINE/PubMed, Scopus, Cochrane, and EMBASE databases were searched for studies investigating noninvasive neuromonitoring in patients with COVID-19 admitted to ICUs. The monitoring included transcranial Doppler ultrasonography (TCD), the Brain4care Corp. cerebral compliance monitor (B4C), optic nerve sheath diameter (ONSD), near infrared spectroscopy, automated pupillometry, and electroencephalography (EEG).Results: Thirty-two studies that investigated noninvasive neuromonitoring techniques in patients with COVID-19 in the ICU were identified from a systematic search of 7001 articles: 1 study investigating TCD, ONSD and pupillometry; 2 studies investigating the B4C device and TCD; 3 studies investigating near infrared spectroscopy and TCD; 4 studies investigating TCD; 1 case series investigating pupillometry, and 21 studies investigating EEG. One hundred and nineteen patients underwent TCD monitoring, 47 pupillometry, 49 ONSD assessment, 50 compliance monitoring with the B4C device, and 900 EEG monitoring. Alterations in cerebral hemodynamics, brain compliance, brain oxygenation, pupillary response, and brain electrophysiological activity were common in patients with COVID-19 admitted to the ICU; these abnormalities were not clearly associated with worse outcome or the development of new neurological complications.Conclusions: The use of noninvasive multimodal neuromonitoring in critically ill COVID-19 patients could be considered to facilitate the detection of neurological derangements. Determining whether such findings allow earlier detection of neurological complications or guide appropriate therapy requires additional studies.

show abstract

Diagnostic Approaches to Acute Neuro-COVID

Cascella

Blasio

2021

Features and Management of Acute and Chronic Neuro-Covid

View full text Add to dashboard Cite

How to monitor the brain in COVID-19 patients?

Cited by 5 publications

References 15 publications

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

Non-Invasive Multimodal Neuromonitoring in Non-Critically Ill Hospitalized Adult Patients With COVID-19: A Systematic Review and Meta-Analysis

The Use of Noninvasive Multimodal Neuromonitoring in Adult Critically Ill Patients With COVID-19 Infection

Diagnostic Approaches to Acute Neuro-COVID

Contact Info

Product

Resources

About