Precision Medicine in Neurocritical Care for Cerebrovascular Disease Cases

被引:3
|
作者
Petersen, Nils H. [1 ,2 ]
Sheth, Kevin N. [2 ,3 ,4 ,5 ,6 ]
Jha, Ruchira M. [2 ,3 ,4 ,5 ,6 ]
机构
[1] Yale Med Sch, Dept Neurol, Div Neurocrit Care & Emergency Neurol, 15 York St,LCI 1003, New Haven, CT 06510 USA
[2] Yale Univ, Sch Med, Dept Neurol, New Haven, CT USA
[3] Yale Univ, Sch Med, Dept Neurosurg, New Haven, CT USA
[4] Barrow Neurol Inst, Dept Neurol, Phoenix, AZ USA
[5] Barrow Neurol Inst, Dept Neurosurg, Phoenix, AZ USA
[6] Barrow Neurol Inst, Dept Translat Neurosci, Phoenix, AZ USA
基金
美国国家卫生研究院;
关键词
cerebrovascular disease; critical care; decision-making; precision medicine; stroke; DELAYED CEREBRAL-ISCHEMIA; QUANTITATIVE EEG; PERFUSION-PRESSURE; CAROTID-ENDARTERECTOMY; TRANSCRANIAL DOPPLER; ENDOVASCULAR THERAPY; MONITORING DATA; BRAIN-TISSUE; STROKE; HEMORRHAGE;
D O I
10.1161/STROKEAHA.122.036402
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Scientific advances have informed many aspects of acute stroke care but have also highlighted the complexity and heterogeneity of cerebrovascular diseases. While practice guidelines are essential in supporting the clinical decision-making process, they may not capture the nuances of individual cases. Personalized stroke care in ICU has traditionally relied on integrating clinical examinations, neuroimaging studies, and physiologic monitoring to develop a treatment plan tailored to the individual patient. However, to realize the potential of precision medicine in stroke, we need advances and evidence in several critical areas, including data capture, clinical phenotyping, serum biomarker development, neuromonitoring, and physiology-based treatment targets. Mathematical tools are being developed to analyze the multitude of data and provide clinicians with real-time information and personalized treatment targets for the critical care management of patients with cerebrovascular diseases. This review summarizes research advances in these areas and outlines principles for translating precision medicine into clinical practice.
引用
收藏
页码:1392 / 1402
页数:11
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