Intracranial Pressure (ICP) Monitoring as Part of Multimodal Monitoring Management of Critical Polytrauma Patients. Correlation Between Optimized Intensive Therapy According to ICP Parameters and Clinical Picture

Luca, Loredana; Rogobete, Alexandru Florin; Bedreag, Ovidiu Horea; Sărăndan, Mirela; Cradigati, Carmen Alina; Păpurică, Marius; Gruneantu, Anelore; Patrut, Raluca; Vernic, Corina; Dumbuleu, Corina Maria; Săndesc, Dorel

doi:10.5152/tjar.2015.56933

Cited by 3 publications

(5 citation statements)

References 21 publications

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“…Therefore, the RQ for fat (VCO 2 /VO 2 ) will be 0.7. Other studies have also presented similar RQ values following fat metabolism, such as RQ for tripalmitin (fat) 0.71, oleic acid (fat) 0.71, and triolein (fat) 0.7 [99][100][101][102][103][104][105][106][107][108][109][110].…”

Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 84%

“…A significant proportion of polytrauma patients is represented by patients with traumatic brain injury (TBI) [2,103,104]. A different aspect, in the case of these patients, is represented by the hemodynamic instability and secondary complications that they develop.…”

Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 99%

“…In addition, the critically ill polytrauma patient is characterized by a series of pathologies and imbalances, all of which are interconnected and have accelerated dynamics. These rapid pathophysiological and metabolic changes lead to an extremely dynamic energy expenditure profile that changes on a daily basis [102][103][104][105][106][107]. On the one hand, the most common changes that lead to an increased energy expenditure (kcal/24 h) are represented by hyperventilation, hyperthermia, overfeeding, infections, inflammation, metabolic acidosis, hyperthyroidism, and pheochromocytoma.…”

Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 99%

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Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

et al. 2019

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The critically ill polytrauma patient is characterized by a series of metabolic changes induced by inflammation, oxidative stress, sepsis, and primary trauma, as well as associated secondary injuries associated. Metabolic and nutritional dysfunction in the critically ill patient is a complex series of imbalances of biochemical and genetic pathways, as well as the interconnection between them. Therefore, the equation changes in comparison to other critical patients or to healthy individuals, in which cases, mathematical equations can be successfully used to predict the energy requirements. Recent studies have shown that indirect calorimetry is one of the most accurate methods for determining the energy requirements in intubated and mechanically ventilated patients. Current research is oriented towards an individualized therapy depending on the energy consumption (kcal/day) of each patient that also takes into account the clinical dynamics. By using indirect calorimetry, one can measure, in real time, both oxygen consumption and carbon dioxide production. Energy requirements (kcal/day) and the respiratory quotient (RQ) can be determined in real time by integrating these dynamic parameters into electronic algorithms. In this manner, nutritional therapy becomes personalized and caters to the patients’ individual needs, helping patients receive the energy substrates they need at each clinically specific time of treatment.

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Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 84%

Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 99%

Section: Nutritional Therapy Guided With Indirect Calorimetrymentioning

confidence: 99%

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Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

et al. 2019

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“…This real-time tracking of cerebral physiology has great potential to guide multimodal treatment of secondary injury following TBI. Certain parameters (ICP, P bt O 2 ) have reliably shown to be effective in guiding treatment of moderate and severely injured TBI patients [ 117 , 197 ]. Ischemia and metabolic disruption in TBI lead to abnormal and pathologic electrical events, including cortical spreading depolarizations (CSDs) which are common after TBI and known to play a role in secondary injury [ 72 , 198 , 199 , 200 ].…”

Section: Discussionmentioning

confidence: 99%

Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Lynch

Narayan

2023

JCM

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Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Despite extensive research efforts, the majority of trialed monotherapies to date have failed to demonstrate significant benefit. It has been suggested that this is due to the complex pathophysiology of TBI, which may possibly be addressed by a combination of therapeutic interventions. In this article, we have reviewed combinations of different pharmacologic treatments, combinations of non-pharmacologic interventions, and combined pharmacologic and non-pharmacologic interventions for TBI. Both preclinical and clinical studies have been included. While promising results have been found in animal models, clinical trials of combination therapies have not yet shown clear benefit. This may possibly be due to their application without consideration of the evolving pathophysiology of TBI. Improvements of this paradigm may come from novel interventions guided by multimodal neuromonitoring and multimodal imaging techniques, as well as the application of multi-targeted non-pharmacologic and endogenous therapies. There also needs to be a greater representation of female subjects in preclinical and clinical studies.

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“…This real time tracking of cerebral physiology has great potential to guide multimodal treatment of secondary injury following TBI. Certain parameters (ICP, PbtO2) have reliably shown to be effective in guiding treatment of moderate and severely injured TBI patients [160,161]. Ischemia and metabolic disruption in TBI leads to abnormal and pathologic electrical events including cortical spreading depolarizations (CSDs) whch are common after TBI and known to play a role in secondary injury [29,[162][163][164].…”

Section: Imaging-and Neuromonitoring-guided Treatmentmentioning

confidence: 99%

Multi-mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Lynch¹,

Narayan²,

Li³

2023

Preprint

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Intracranial Pressure (ICP) Monitoring as Part of Multimodal Monitoring Management of Critical Polytrauma Patients. Correlation Between Optimized Intensive Therapy According to ICP Parameters and Clinical Picture

Cited by 3 publications

References 21 publications

Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

Assessment of Metabolic and Nutritional Imbalance in Mechanically Ventilated Multiple Trauma Patients: From Molecular to Clinical Outcomes

Multi-Mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

Multi-mechanistic Approaches to the Treatment of Traumatic Brain Injury: A Review

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