[Multimodal neuromonitoring in traumatic brain injury: contribution of PTiO2]. / Neuromonitorización multimodal en el TCE: aportación de la PTiO2.

The main goal of exhaustively monitoring neurocritical patients is to avoid secondary injury. In the last few years we have witnessed an increase in brain monitoring tools, beyond the checking of intracranial and brain perfusion pressures. These widely used systems offer valuable but possibly insufficient information. Awareness and correction of brain hypoxia is a useful and interesting measure, not only for diagnostic purposes but also when deciding treatment, and to predict an outcome. In this context, it would be of great interest to use all the information gathered from brain oxygenation monitoring systems in conjunction with other available multimodal monitoring devices, in order to offer individualized treatment for each patient.

[Prone positioning in patients with intracranial hypertension and severe acute respiratory failure]. / Decúbito prono en pacientes con hipertensión endocraneal e insuficiencia respiratoria aguda grave.

Prone positioning has been used to improve gas exchange in mechanically ventilated patients with severe acute respiratory failure. Brain injured patients have been excluded from this therapy due to its potential effects on intracranial pressure. Nonetheless, these patients are extremely sensible to hypoxemia, and their prognosis worsens dramatically when acute respiratory failure appears. We present three cases of brain injured patients (two with traumatic brain injury and one with intracerebral hemorrhage) with severe acute respiratory failure who were managed with prone positioning. Neurologic and respiratory outcomes were not unfavorable. We provide a brief review of the literature related to this matter.