|August 2010||Vol. 1 No. 1|
Welcome to the first edition of The Neuroscience Monitor. Actually this is the resurrection of a whimsical newsletter written by Dick Moberg in the mid-1990s about neuromonitoring. A lot has changed since then. The goal of this newsletter is to help you keep up with neuromonitoring with an emphasis on neurocritical care. We plan to keep the newsletter fun and informative. We will also use the newsletter to provide updates on our products and users. We encourage you to contribute and we hope you like it.
Dr. Yonas' vision is for the ICU to become a state-of-the-art center for multimodality neuromonitoring where devices, analysis tools, imaging, and patient records are all seamlessly integrated. Thus, in 2006, and with subsequent support from the Army and the National Institutes of Health, we started developing the informatics infrastructure to help Dr. Yonas achieve his vision.
One part of this collaboration is that UNM is a partner with us in the Army's Hospital of the Future program. The goal is to develop a standards-based "open system" that can communicate with information "sources" (monitors, imaging, etc.) and store the information in a common format where it is usable by information "users" such as analysis tools (e.g., ICM+, ICUPilot, statistical programs, etc.), decision support tools, and the electronic patient record.
A recent addition and core component of UNM's ICU infrastructure is our CNS Multimodality Monitor that collects data from many of these vital signs monitors and other specialty neuromonitoring devices at the bedside. The data is time synchronized and can be displayed in a variety of formats to detect changes in the trends. Multiple CNS Monitors are now in place at UNM and are incorporated into the hospital network so that the data can be viewed remotely from each system. Multi-channel EEG can also be collected and processed at each bedside and can be viewed in the EEG lab using third-party software (the Persyst EEG Suite).
The goal of "seamless collection of data" from multiple diverse sources is a lofty one. However, several companies agreed to partner with us for device integration at UNM and elsewhere including Hemedex (Bowman Perfusion Monitor), Somanetics (INVOS monitor), Integra (Licox and Camino monitors), Philips (vital signs monitors), GE (vital signs monitors), Persyst Development (EEG review & analysis software), Neurologica (portable CT scanners), and Cincinnati Sub-Zero (Blanketrol cooling system).
We have learned a lot from working with UNM and the job has not always been easy. For example, because the serial data output from the GE vital signs monitors at UNM was being used by an electronic patient record system, we had to develop an alternate Ethernet interface to collect the vital signs data. Similarly, when we learned that UNM wanted to record ICP from two locations simultaneously, we needed to modify our measurement labeling paradigm to enable this collection. Throughout the process the team at UNM has been a pleasure to work with and their feedback has been invaluable.
According to Dr. Yonas, UNM's focus is on patients with head trauma as well as hemorrhagic and ischemic stroke. Over the past decades, Dr. Yonas has conducted pioneering work in the quantification of cerebral blood flow and now, with multimodality monitoring, his interest is on combining CBF with continuous physiological measurements. They have observed that high ICP is frequently due to high flow and that blood pressure elevation to "improve" CPP can paradoxically lower CBF.
As a collaborator, the University has some additional "resources" that make it a particularly attractive place for our work. The Mind Research Network (MRN) is an independent non-profit research organization focusing on mental illness and brain injury. Also in Albuquerque is Sandia National Laboratories. Sandia is a national laboratory involved in a variety of research and development programs for energy, security, and defense. One area of expertise that makes Sandia interesting for work in neuromonitoring is their ability to analyze large quantities of time series data with their super computers.
Dr. Yonas recently told us that one of the reasons he moved to Albuquerque was that his brother (also "Dr. Yonas") ran the Advanced Project Group at Sandia National Laboratories, where he was involved in much of their defense and weapons research. He said, to distinguish the two, he was called "Dr. Life" and, you guessed it, his brother was called "Dr. Death".
The University of New Mexico is sponsoring the upcoming meeting "Clinical Integration of Tomographic Physiological Imaging and Multimodal Monitoring: Present and Future", August 26-28. See the Events section for details.
August 26-28, 2010
Clinical Integration of Tomographic Physiological Imaging and Multimodal Monitoring - Present and Future
Buffalo Thunder Resort and Casino
Santa Fe, New Mexico
September 15-18, 2010
Neurocritical Care Society
San Francisco Marriott Marquis
San Francisco, CA
October 7-9, 2010
Neurocritical Care 2010
A Global Conference of Neurocritical Care and Music
Case Western Reserve University
October 9, 2010
Third Annual Case Western Reserve University Critical Care Bioinformatics Workshop
Case Western Reserve University
October 14-15, 2010
Society for Neuroscience in Anesthesiology and Critical Care, 38th Annual Meeting
Hilton San Diego Bayfront Hotel
San Diego, CA
October 16-21, 2010
Congress of Neurological Surgeons
Moscone West Convention Center
San Francisco, CA
Elevated cerebral pressure passivity is associated with prematurity-related intracranial hemorrhage.
Pediatrics. 2009 Jul;124(1):302-9
O'Leary H, Gregas MC, Limperopoulos C, Zaretskaya I, Bassan H, Soul JS, Di Salvo DN, du Plessis AJ.
Intracranial multimodal monitoring for acute brain injury: a single institution review of current practices.
Neurocrit Care. 2010 Apr;12(2):188-98.
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J.
Reactivity of brain tissue oxygen to change in cerebral perfusion pressure in head injured patients.
Neurocrit Care. 2009;10(3):274-9. Epub 2009 Jan 30.
Radolovich DK, Czosnyka M, Timofeev I, Lavinio A, Hutchinson P, Gupta A, Pickard JD, Smielewski P.
Monitoring of cerebrovascular autoregulation: facts, myths, and missing links.
Neurocrit Care. 2009;10(3):373-86. Epub 2009 Jan 6.
Czosnyka M, Brady K, Reinhard M, Smielewski P, Steiner LA.
Multimodal monitoring in traumatic brain injury: current status and future directions.
Tisdall MM, Smith M.
Br J Anaesth. 2007 Jul;99(1):61-7. Epub 2007 Jun 4.
We are pleased to announce our Research Partners program. As many of you know, the parent company of CNS Technology (Moberg Research, Inc.) and its predecessors have been actively involved in neuromonitoring research for three decades. These companies have been the recipient of numerous NIH and DoD grants related to neuromonitoring which have led to new monitoring technology including neonatal seizure detection and a neonatal brain wellness index as well as an advanced multimodality neuromonitoring system. Over the years we have developed some excellent research partnerships which have been beneficial to our company as well as to our academic and clinical partners. If you would like more information, contact Mr. Damon Lees at firstname.lastname@example.org.
EEG, video, and all other physiological data recorded with the CNS Monitor can be viewed away from the bedside using Persyst EEG Suite software.
Compatibility with the CNS Monitor
Review and Analysis Features of the Persyst EEG Suite
Installation and Support of the Persyst EEG Suite
This newsletter is brought to you by CNS Technology. CNS Technology, LLC is an affiliate of Moberg Research, Inc.
The "Component Neuromonitoring System" and "The Neuroscience Monitor" are trademarks of Moberg Research, Inc. All other trademarks, service marks, company names, and publications that may be identified within this newsletter are the property of their respective owners.