Monitoring Brain and Spinal Cord Metabolism and Function

Abstract

Monitoring the metabolism and function of the central nervous system not\ronly is an old idea but also is a topic that\ris of increasing interest to the technological evolution. Beside the\roptimization of cerebral and spinal cord perfusion and the preservation\rof vasoreactivity to ensure the viability of cerebral tissues and structures,\rwe want to know more and more about the real intimate situation of these organs\rin real time at the patient’s bedside. To this end, several tracks have been\rexplored during the two last decades, leading to the development of numerous\rconcepts and the conception of various monitoring systems. One of the main\rproblems is to characterize the respective strong points and weaknesses of\rthose ones and to conclude regarding their individual relevance and value in\rcurrent clinical practice. It is more and more clear that the combination of\rdifferent categories of monitoring is a way to try to find the most valuable\rtechnological compromise, to increase the\rchance of prediction or of early detection of intercurrent deleterious events corresponding to the concept of multimodality. The intraoperative period and the\rintensive care goals and targets are appreciably different. This is the reason\rfor the attempt to define different and distinct sets of goals and targets for the\rintraoperative anesthetic setting and for the intensive care unit.