Neuromonitoring in the Intensive Care Unit.

This issue of Critical Care Nursing Clinics of North America is focused on neuromonitoring in the intensive care unit (ICU). Neuromonitoring is a broad umbrella term that elicits different concepts depending on a person’s role in the ICU. For instance, a trauma nurse may associate neuromonitoring with intracranial bolts, whereas an ultrasound technician may immediately think of transcranial Dopplers. A neuro ICU nurse may have visions of going to multiple scans or working with external ventricular drains. The term neuromonitoring includes all these concepts as well as more, which are discussed within this dedicated issue of Critical Care Nursing Clinics of North America. In designing this issue, we created three overriding themes of neuromonitoring that remained fairly broad. First, we thought of traditional methods of neuromonitoring that a nurse would expect to see in this issue. Robinson goes into depth on treating refractory increased intracranial pressures, while Heck discusses different modalities that are available for using invasive neuromonitoring for patients. Irick and Feil provide an extremely helpful overview of neuromonitoring in the operating room. Many ICU nurses are not familiar with neuromonitoring in the operating room, and the literature is resource-poor in this area. Therefore, the collaborative approach from Irick and Feil not only provides a better understanding of neuromonitoring but also gives nurses a glimpse into the role of the nurse anesthetist. The second approach we took on neuromonitoring was to explore novel concepts and products. Hylkema provides a look at one of the newest concepts of using optic sheath ultrasound as a method for assessing intracranial pressures noninvasively. The use of ultrasound has grown exponentially over the years due to its ease of use, low cost, and accessibility. Hylkema provides an overview of how it is being used for neurologic patients. Few centers have microdialysis, but the road on how to use it is being mapped by Kumar and Young in this issue. Even if your hospital setting does not use microdialysis, there is tremendous value in understanding brain metabolism. Wilson and Della Penna present evidenced-based research on the value of