Technology

The Neuro-ICU is committed to modern excellence and is outfitted with cutting edge technological and multi-modality monitoring devices found only in the most pioneering neuro-intensive care units.

Cooling Devices


The Arctic sun provides controlled surface cooling and rewarming through patented hydrogel pads. The arctic sun is used for induced hypothermia and for fever control.
For assistance contact: 631-375-6641.
Nurse champions: Beatrice Davis, Eleth Palmer, Shirlene Watson, Ella Pelobello

 


The Innercool Celcius Control System is an endovascular cooling device that provides efficient cooling via a catheter that is placed in the groin. The Innercool is used for induced hypothermia and for fever control.
For assistance contact: 314-308-2178.
Nurse champions: Beatrice Davis, Eleth Palmer, Shirlene Watson, Ella Pelobello

 

Intracranial Pressure Monitors


External ventricular drains (EVD) are placed at the bedside through the skull and into the ventricles (fluid filled spaces) in the brain. EVDs provide a gold standard estimate of intracranial pressure (ICP) and allow for drainage of cerebral spinal fluid. Special antibiotic coated EVDs and EVDs with fiberoptic ICP transducers are used in certain circumstances.
For assistance contact: 908-672-2616 or 917-324-6524.

 


Parenchymal ICP monitoring devices are placed at the bedside through a bolt or tunneled through a craniotomy defect and provide regional measures of ICP. Our ICU typically uses double or triple lumen bolts allowing for simultaneous placement of an ICP monitor, microdialysis, Licox and brain temperature monitors. Single lumen bolts may be utilized in coagulopathic patients as they carry the least risk of hemorrhage. Parenchymal ICP monitors have lower risks of infection and hemorrhage than EVDs, but do not allow for CSF diversion.
For assistance contact: 908-672-2616 or 917-324-6524.
Nurse champions: Mary Ann Jones-Johnson, Sabrina Chan Look, Elsie Mbele

 

Multi-Modality Monitoring


The Licox is a fiberoptic filament that is placed via a bolt through the skull into the white matter of the brain or tunneled through a craniotomy defect. It measures an average of capillary and parenchymal brain oxygen tension (mm Hg). The Licox does not directly measure oxygen extraction fraction or oxygen delivery, but can be a useful marker of tissue distress when combined with other multi-modality monitoring devices such as intracranial pressure monitoring and microdialysis. Licox values can guide physicians in titrating blood pressure, volume status and transfusions.
For assistance contact: 908-672-2616 or 917-324-6524.
Nurse champions: Mary Ann Jones-Johnson, Sabrina Chan Look, Elsie Mbele

 

Microdialysis is performed through a small catheter placed through a bolt or tunneled at the bedside into the brain white matter. Interstitial fluid collected via microdialysis is analyzed for lactate, pyruvate, glucose, glutamate and glycerol levels. Changes in the absolute values or ratios of these metabolites can indicate brain injury or distress. Microdialysis is part of multi-modality monitoring and allows physicians to tailor therapy (blood pressure, transfusion, oxygenation) to meet a patient’s specific needs and to preserve viability of penumbral brain tissue.
For assistance contact: 800-440-4980 x25.
Nurse champions: Denise Gaynor-Mercado, Juanita Co-Ng, Teodora Romano, Eun Sun Lee, Shirlene Watson

 

Bedside Laboratory Assessment

Thromboelastography (TEG) - This bedside device utilizes small samples of blood to assess the activity of the coagulation system, platelet function and fibrinolysis. TEG can help guide coagulopathy reversal and assist in detection of hypercoagulable states.
For assistance contact: 210-835-4291 or 800-229-2290 ext 227.
Nurse champions: Cynthia Fernandez, Lorena Vivas, Shirlene Watson, Rita Ramdial, Dolores Navarro-Outerbridge

 

Doppler/Ultrasound


Transcranial Doppler: Our Viasys/Nicolet 8080 transcranial Doppler (TCD) allows for dual channel monitoring with multiple waveform analog input. Standard transcranial Dopplers are performed by our neuro-intensivists (Drs. Frontera and Gordon) on all of our subarachnoid hemorrhage patients, but also as needed on neurovascular and severe brain injury patients (confirmation of the brain death exam etc.). Our TCD is capable of bilateral monitoring for autoregulation testing (with CO2 challenge or dynamic cerebral autoregulation), HITS (high intensity transient signal monitoring) and patent foramen ovale testing.
For assistance contact: 800-356-0007 ext 2311 or 281-622-5094.

 

Echocardiography - Bedside echocardiography not only provides structural information but can provide information on volume status and cardiac function.

 

Ultrasound - Central Lines are placed under direct ultrasound visualization. This technique has been shown to lower complications related to line placement.

 

EEG


Electroencephalography (EEG) - The neuro-intensive care unit has 6 dedicated portable XLTEK EEG monitoring carts, a reading station in the neuro-ICU and remote access to all EEG files via a dedicated Citrix server. Each of the 16 beds is wired for EEG monitoring. All EEG carts also provide compressed spectral array and quantitative EEG analysis capabilities.
For assistance contact: 914-474-3831.
Nurse champions: Carol McGowan, Kathy Nanry-Mathieu, Andrea Mohan

 

Airway Management


The Glidescope is a video-assisted intubation device. This device is ideal in neurological patients with elevated ICP or C spine immobilization and ENT patients with complicated anatomy because intubation can be easily performed in a neutral neck position with minimal glottis stimulation. That physicians assisting the laryngoscopist in intubation can visualize the oropharynx on a large screen minimizes the risk of the intubation and allows for instruction of trainees. The neuro-ICU staff performs its own intubations but has access to assistance from neuroanesthesia and ENT for particularly difficult airways.
For assistance contact: 646-842-0851.
Nurse champions: Marylou Castanares-Galang, Nandini Paranjape, Dolores Navarro-Outerbridge

 


Bronchoscopy - The neuro-intensive care unit has a dedicated bronchoscope (Olympus, Center Valley, PA) that can be used both diagnostically and therapeutically for lung collapse, mucous plugging, sputum sampling etc.
For assistance contact: 800-645-8100 x106911.

 

Cardiac Monitoring


Non-invasive cardiac monitoring - The Flotrak provides a minimally invasive continuous measure of cardiac output, cardiac index, and stroke volume variation via arterial waveform analysis. This device has been used as an alternative to the pulmonary artery catheter.
For assistance contact: 914-329-5579.
Nurse champions: Denise Gaynor-Mercado, Pilar Gormley, Marissa Flores

 

Data Analysis


The Bedmaster system is a data collection system in use at each bedside that samples physiologic parametric and waveform data at a frequency of 256 Hz. This data can be analyzed retrospectively and graphed to determine trends and relationships between physiologic variables, medications, ventilator settings or other patient care interventions. This powerful data collection tool also allows for off line sophisticated waveform analysis that can be applied toward patient management.
For assistance contact: Mount Sinai IT or 215-262-2699.


Contact Us

Neuroscience ICU
Tel: 212-241-2100
Fax: 212-426-7629

Annenberg Building
1468 Madison Avenue
8th Floor
New York, NY 10029