Advanced neuromonitoring techniques for medical and neurological ICU patients

Newly developed neurological complications are not confined to patients admitted to the neurology ICU but also occur in the medical ICU. In addition to patients with traumatic brain injuries, critically ill patients with sepsis, encephalopathy, and post-cardiopulmonary resuscitation are at risk of d...

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Main Authors: Reza Eshraghi, Mohammad Sepehr Yazdani, Ashkan Bahrami, Reza Amani-Beni, Bahar Darouei, Majid Mokhtari, Seyed MohammadReza Hashemian
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:Brain Research Bulletin
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Online Access:http://www.sciencedirect.com/science/article/pii/S0361923025003259
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author Reza Eshraghi
Mohammad Sepehr Yazdani
Ashkan Bahrami
Reza Amani-Beni
Bahar Darouei
Majid Mokhtari
Seyed MohammadReza Hashemian
author_facet Reza Eshraghi
Mohammad Sepehr Yazdani
Ashkan Bahrami
Reza Amani-Beni
Bahar Darouei
Majid Mokhtari
Seyed MohammadReza Hashemian
author_sort Reza Eshraghi
collection DOAJ
description Newly developed neurological complications are not confined to patients admitted to the neurology ICU but also occur in the medical ICU. In addition to patients with traumatic brain injuries, critically ill patients with sepsis, encephalopathy, and post-cardiopulmonary resuscitation are at risk of developing neurological complications. The situation can worsen when patients are sedated and intubated, which prevents the clinical manifestations to be presented. In this regard, non-convulsive seizures and status epilepticus, new onset strokes, and neuromuscular weakness syndromes could be missed which escalates the prognosis. The advancement of neuromonitoring technology enables real-time, multimodal assessments of brain functions, improving the ability of clinicians to detect and preemptively address potential neurological complications. In this study, we reviewed which certain neurological and medical conditions pose a high risk for developing secondary or new-onset neurological complications. Additionally, we reviewed various approaches that can assist in detecting these complications, including automated pupillometry, Bispectral Index monitoring, electroencephalogram, somatosensory evoked potentials monitoring, jugular venous oxygen saturation monitoring, PbO2 monitoring, near-infrared spectroscopy, transcranial Doppler sonography, thermal diffusion flowmetry, cerebral perfusion pressure monitoring, and biomarkers associated with neuronal damage. Last but not least, we reviewed the potential of integrating artificial intelligence in the ICU.
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spelling doaj-art-c3248ac777fc471db5a71120988ee8252025-08-23T04:47:26ZengElsevierBrain Research Bulletin1873-27472025-10-0123011151310.1016/j.brainresbull.2025.111513Advanced neuromonitoring techniques for medical and neurological ICU patientsReza Eshraghi0Mohammad Sepehr Yazdani1Ashkan Bahrami2Reza Amani-Beni3Bahar Darouei4Majid Mokhtari5Seyed MohammadReza Hashemian6Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran; Corresponding author.Student Research Committee, Kashan University of Medical Sciences, Kashan, IranClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, IranHeart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IranAnesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, IranPulmonary and Critical Care Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, IranClinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Correspondence to: Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran 1983969411, Iran.Newly developed neurological complications are not confined to patients admitted to the neurology ICU but also occur in the medical ICU. In addition to patients with traumatic brain injuries, critically ill patients with sepsis, encephalopathy, and post-cardiopulmonary resuscitation are at risk of developing neurological complications. The situation can worsen when patients are sedated and intubated, which prevents the clinical manifestations to be presented. In this regard, non-convulsive seizures and status epilepticus, new onset strokes, and neuromuscular weakness syndromes could be missed which escalates the prognosis. The advancement of neuromonitoring technology enables real-time, multimodal assessments of brain functions, improving the ability of clinicians to detect and preemptively address potential neurological complications. In this study, we reviewed which certain neurological and medical conditions pose a high risk for developing secondary or new-onset neurological complications. Additionally, we reviewed various approaches that can assist in detecting these complications, including automated pupillometry, Bispectral Index monitoring, electroencephalogram, somatosensory evoked potentials monitoring, jugular venous oxygen saturation monitoring, PbO2 monitoring, near-infrared spectroscopy, transcranial Doppler sonography, thermal diffusion flowmetry, cerebral perfusion pressure monitoring, and biomarkers associated with neuronal damage. Last but not least, we reviewed the potential of integrating artificial intelligence in the ICU.http://www.sciencedirect.com/science/article/pii/S0361923025003259NeuromonitoringIntensive care unitCritical ill patientsArtificial intelligenceMultimodal assessment
spellingShingle Reza Eshraghi
Mohammad Sepehr Yazdani
Ashkan Bahrami
Reza Amani-Beni
Bahar Darouei
Majid Mokhtari
Seyed MohammadReza Hashemian
Advanced neuromonitoring techniques for medical and neurological ICU patients
Brain Research Bulletin
Neuromonitoring
Intensive care unit
Critical ill patients
Artificial intelligence
Multimodal assessment
title Advanced neuromonitoring techniques for medical and neurological ICU patients
title_full Advanced neuromonitoring techniques for medical and neurological ICU patients
title_fullStr Advanced neuromonitoring techniques for medical and neurological ICU patients
title_full_unstemmed Advanced neuromonitoring techniques for medical and neurological ICU patients
title_short Advanced neuromonitoring techniques for medical and neurological ICU patients
title_sort advanced neuromonitoring techniques for medical and neurological icu patients
topic Neuromonitoring
Intensive care unit
Critical ill patients
Artificial intelligence
Multimodal assessment
url http://www.sciencedirect.com/science/article/pii/S0361923025003259
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