Monitoring brain oxygenation and intracranial pressure non-invasively and continuously is of paramount importance in traumatic brain injury (TBI). The primary motivation of this study was to identify and provide robust evidence of the most effective techniques for the non-invasive multimodal monitoring for traumatic brain injury. Two reviewers independently searched PubMed, Embase, Scopus, the Cochrane Library, and the Web of Science between January 15, 2010, and January 22, 2020. Cohort studies assessing correlation or accuracy of non-invasive techniques for intracranial pressure (ICP) and/or brain oxygenation monitoring in TBI patients were included. The Newcastle–Ottawa Scale was used to assess the methodological quality of the studies. PROSPERO registration ID is CRD42020164739. Eight out of the 12 studies selected focused on the non-invasive measurement of ICP. Near-Infrared spectroscopy was the main technology for brain oxygenation, whereas ultrasound-based techniques were also used for ICP monitoring. PbtO₂ monitoring through near-infrared spectroscopy showed low correlation and limited accuracy in detecting hypoxic events. A meta-analysis on non-invasive ICP monitoring revealed a strong pooled correlation coefficient of 0.725 (95 % confidence interval [CI]: 0.450–0.874; I² 91.31%) between transcranial Doppler and the gold standard ICP monitoring. The current meta-analysis has shown that the two most prominent and widely used technologies for non-invasive monitoring in TBI are near-infrared spectroscopy and transcranial Doppler. Both techniques could be considered for the future development of a single non-invasive and continuous multimodal monitoring device for TBI.

中文翻译：

---

创伤性脑损伤多模式监测的无创技术：系统评价和荟萃分析。

无创和持续监测脑氧合和颅内压对于创伤性脑损伤 (TBI) 至关重要。本研究的主要动机是确定并提供强有力的证据，证明最有效的技术可用于外伤性脑损伤的无创多模式监测。2010 年 1 月 15 日至 2020 年 1 月 22 日期间，两名评审员独立检索了 PubMed、Embase、Scopus、Cochrane 图书馆和 Web of Science。队列研究评估了颅内压 (ICP) 和/或非侵入性技术的相关性或准确性或 TBI 患者的脑氧合监测包括在内。纽卡斯尔-渥太华量表用于评估研究的方法学质量。PROSPERO 注册 ID 是 CRD42020164739。选定的 12 项研究中有 8 项侧重于 ICP 的无创测量。近红外光谱是脑氧合的主要技术，而基于超声的技术也用于 ICP 监测。氧化铅₂通过近红外光谱监测显示低相关性和检测缺氧事件的准确性有限。一项关于无创 ICP 监测的荟萃分析显示，经颅多普勒和金标准 ICP 监测之间的强合并相关系数为 0.725（95% 置信区间 [CI]：0.450–0.874；I ² 91.31%）。目前的荟萃分析表明，近红外光谱和经颅多普勒是 TBI 中最突出和应用最广泛的两种无创监测技术。这两种技术都可以考虑用于未来开发用于 TBI 的单一非侵入性和连续多模式监测设备。