Neurointensive care, traumatic brain injury and subarachnoid hemorrhage
Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are common and serious conditions. The development of modern neurointensive care (NIC) has markedly reduced mortality and improved patient outcomes. The NIC unit with highly standardized care, a multitude of monitoring methods and powerful computerized systems for data collection and analysis provides an excellent platform for explorative studies of pathophysiology in humans and development of new monitoring techniques and new management strategies. The research also covers other aspects of TBI and SAH beside the NIC research and also includes other acute conditions.
Project description
The general aim is study pathophysiology and management of acute brain injury in humans with the ultimate goal to develop the NIC and the clinical management in order to improve clinical outcome.
A unique platform for explorative research has been established at the NIC unit including several corner stones:
- Standardized care – A standardized clinical protocol system, corresponding to the concept of good laboratory practice (GLP), has been developed and implemented in the NIC unit.
- Multimodality monitoring – Technical methods are available for monitoring of for example intracranial pressure (ICP), systemic blood pressure, cerebral perfusion pressure (CPP), neurochemical changes (e.g. energy metabolites and biomarkers), neurophysiology (EEG changes), brain temperature, brain tissue oxygen pressure, venous oxygen saturation, cerebral blood flow velocity and intracranial compliance.
- Computerized data management system – The Odin browser has been developed and implemented in the NIC unit for collection, analysis and visualization of high resolution monitoring data.
- Quality registers – A quality register for TBI has been established (The Uppsala TBI register) at Uppsala clinical research center (UCR) and databases for SAH and other types of brain injuries at the NIC unit.
- Neuroimaging – The NIC unit is equipped with a mobile CT-scanner.
Examples of studies
Examples of ongoing studies with the research areas of neurointensive care, traumatic brain injury and subarachnoid hemorrhage are:
- Studies of intracranial pressure dynamics and compliance
- Studies of secondary insults
- AI models for prediction of ICP insults in advance
- CBF pressure autoregulation (PRx)
- Brain tissue oxygenation
- HHH-therapy in SAH
- Neurochemical microdialysis studies
- Biomarkers
- Neuro inflammation
- Studies of NIC management in elderly TBI patients
- Studies of NIC management in pediatric TBI
- Studies of Moyamoya (Center for National highly specialized care)
- Studies of craniofacial malformations (Center for National highly specialized care)
- Detailed follow-up studies