Monitoring of Optimal Cerebral Perfusion Pressure in Traumatic Brain Injured Patients Using a Multi-Window Weighting Algorithm
| Autor: | Ari Ercole, Marek Czosnyka, Xiuyun Liu, Joseph Donnelly, Manuel Cabeleira, Danilo Cardim, Dong-Joo Kim, Peter Smielewski, Natasha M. Maurits, Marcel J. H. Aries, Celeste Dias |
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| Přispěvatelé: | Liu, Xiuyun [0000-0001-9540-4865], Czosnyka, Marek [0000-0003-2446-8006], Ercole, Ari [0000-0001-8350-8093], Donnelly, Joseph [0000-0002-6502-8069], Cardim, Danilo [0000-0002-9261-1321], Smielewski, Peter [0000-0001-5096-3938], Apollo - University of Cambridge Repository, RS: FHML non-thematic output, Intensive Care, MUMC+: MA Medische Staf IC (9), Movement Disorder (MD), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty cerebral autoregulation Intracranial Pressure Traumatic brain injury Glasgow Outcome Scale CHILDREN multi-window algorithm Cerebral autoregulation 03 medical and health sciences Young Adult 0302 clinical medicine Time windows Internal medicine TBI Brain Injuries Traumatic Outcome Assessment Health Care medicine MANAGEMENT Humans Autoregulation Arterial Pressure Glasgow Coma Scale Cerebral perfusion pressure Retrospective Studies CPPopt Calculation algorithm Reproducibility of Results 030208 emergency & critical care medicine SEVERE HEAD-INJURY AUTOREGULATION Middle Aged medicine.disease Neurophysiological Monitoring REACTIVITY Pressure reactivity Weighting Anesthesia pressure reactivity index Cerebrovascular Circulation Data Interpretation Statistical Cardiology Female Neurology (clinical) Psychology 030217 neurology & neurosurgery Algorithms |
| Zdroj: | Journal of Neurotrauma, 34(22), 3081-3088. Mary Ann Liebert Inc. Journal of Neurotrauma, 34(22), 3081-3088. MARY ANN LIEBERT, INC |
| ISSN: | 0897-7151 |
| DOI: | 10.17863/cam.15823 |
| Popis: | Methods to identify an autoregulation guided "optimal'' cerebral perfusion pressure (CPPopt) for traumatic brain injury patients (TBI) have been reported through several studies. An important drawback of existing methodology is that CPPopt can be calculated only in similar to 50-60% of the monitoring time. In this study, we hypothesized that the CPPopt yield and the continuity can be improved significantly through application of a multi-window and weighting calculation algorithm, without adversely affecting preservation of its prognostic value. Data of 526 severe TBI patients admitted between 2003 and 2015 were studied. The multi-window CPPopt calculation was based on automated curve fitting in pressure reactivity index (PRx)-CPP plots using data from 36 increasing length time windows (2-8 h). The resulting matrix of CPPopts was then averaged in a weighted manner. The yield, continuity, and stability of CPPopt were studied. The difference between patients' actual CPP and CPPopt (DCPP) was calculated and the association with outcome was analyzed. Overall, the multi-window method demonstrated more continuous and stable presentation of CPPopt in this cohort. The new method resulted in a mean (+/- SE) CPPopt yield of 94%+/- 2.1%, as opposed to the previous single-window-based CPPopt yield of 51%+/- 0.94%. The stability of CPPopt across the whole monitoring period was significantly improved by using the new algorithm (p |
| Databáze: | OpenAIRE |
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