Consensus Summary Statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: A statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine

Peter Le Roux*, David K. Menon, Giuseppe Citerio, Paul Vespa, Mary Kay Bader, Gretchen M. Brophy, Michael N. Diringer, Nino Stocchetti, Walter Videtta, Rocco Armonda, Neeraj Badjatia, Julian Böesel, Randall Chesnut, Sherry Chou, Jan Claassen, Marek Czosnyka, Michael De Georgia, Anthony Figaji, Jennifer Fugate, Raimund HelbokDavid Horowitz, Peter Hutchinson, Monisha Kumar, Molly McNett, Chad Miller, Andrew Naidech, Mauro Oddo, Dai Wai Olson, Kristine O’Phelan, J. Javier Provencio, Corinna Puppo, Richard Riker, Claudia Robertson, Michael Schmidt, Fabio Taccone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

102 Scopus citations

Abstract

Neurocritical care depends, in part, on careful patient monitoring but as yet there are little data on what processes are the most important to monitor, how these should be monitored, and whether monitoring these processes is cost-effective and impacts outcome. At the same time, bioinformatics is a rapidly emerging field in critical care but as yet there is little agreement or standardization on what information is important and how it should be displayed and analyzed. The Neurocritical Care Society in collaboration with the European Society of Intensive Care Medicine, the Society for Critical Care Medicine, and the Latin America Brain Injury Consortium organized an international, multidisciplinary consensus conference to begin to address these needs. International experts from neurosurgery, neurocritical care, neurology, critical care, neuroanesthesiology, nursing, pharmacy, and informatics were recruited on the basis of their research, publication record, and expertise. They undertook a systematic literature review to develop recommendations about specific topics on physiologic processes important to the care of patients with disorders that require neurocritical care. This review does not make recommendations about treatment, imaging, and intraoperative monitoring. A multidisciplinary jury, selected for their expertise in clinical investigation and development of practice guidelines, guided this process. The GRADE system was used to develop recommendations based on literature review, discussion, integrating the literature with the participants’ collective experience, and critical review by an impartial jury. Emphasis was placed on the principle that recommendations should be based on both data quality and on trade-offs and translation into clinical practice. Strong consideration was given to providing pragmatic guidance and recommendations for bedside neuromonitoring, even in the absence of high quality data.

Original languageEnglish (US)
Pages (from-to)1-26
Number of pages26
JournalNeurocritical Care
Volume21
Issue number2
DOIs
StatePublished - Oct 1 2014

Keywords

  • Bioinformatics
  • Biomarkers
  • Brain metabolism
  • Brain oxygen
  • Brain physiology
  • Clinical guidelines
  • Clinical trials
  • Consensus development conference
  • Grading of Recommendations Assessment Development and Evaluation (GRADE)
  • Intracranial pressure
  • Microdialysis
  • Multimodal monitoring
  • Neurocritical care
  • Neuromonitoring
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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