Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury: a CENTER-TBI study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Early hyperoxemia is associated with lower adjusted mortality after severe trauma: results from a French registry

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Assessment of pulmonary surfactant in COVID-19 patients

    Publikation: Bidrag til tidsskriftLetterpeer review

  3. Copeptin as a marker of outcome after cardiac arrest: a sub-study of the TTM trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Understanding the relationship between cognitive performance and function in daily life after traumatic brain injury

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Does continuous electroencephalography influence therapeutic decisions in neurocritical care?

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Resting-State NIRS-EEG in Unresponsive Patients with Acute Brain Injury: A Proof-of-Concept Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Lennart Riemann
  • Erta Beqiri
  • Peter Smielewski
  • Marek Czosnyka
  • Nino Stocchetti
  • Oliver Sakowitz
  • Klaus Zweckberger
  • Andreas Unterberg
  • Alexander Younsi
  • CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators
  • Daniel Kondziella (Medlem af forfattergruppering)
  • Kirsten Møller (Medlem af forfattergruppering)
Vis graf over relationer

BACKGROUND: After traumatic brain injury (TBI), brain tissue can be further damaged when cerebral autoregulation is impaired. Managing cerebral perfusion pressure (CPP) according to computed "optimal CPP" values based on cerebrovascular reactivity indices might contribute to preventing such secondary injuries. In this study, we examined the discriminative value of a low-resolution long pressure reactivity index (LPRx) and its derived "optimal CPP" in comparison to the well-established high-resolution pressure reactivity index (PRx).

METHODS: Using the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study dataset, the association of LPRx (correlation between 1-min averages of intracranial pressure and arterial blood pressure over a moving time frame of 20 min) and PRx (correlation between 10-s averages of intracranial pressure and arterial blood pressure over a moving time frame of 5 min) to outcome was assessed and compared using univariate and multivariate regression analysis. "Optimal CPP" values were calculated using a multi-window algorithm that was based on either LPRx or PRx, and their discriminative ability was compared.

RESULTS: LPRx and PRx were both significant predictors of mortality in univariate and multivariate regression analysis, but PRx displayed a higher discriminative ability. Similarly, deviations of actual CPP from "optimal CPP" values calculated from each index were significantly associated with outcome in univariate and multivariate analysis. "Optimal CPP" based on PRx, however, trended towards more precise predictions.

CONCLUSIONS: LPRx and its derived "optimal CPP" which are based on low-resolution data were significantly associated with outcome after TBI. However, they did not reach the discriminative ability of the high-resolution PRx and its derived "optimal CPP." Nevertheless, LPRx might still be an interesting tool to assess cerebrovascular reactivity in centers without high-resolution signal monitoring.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02210221. First submitted July 29, 2014. First posted August 6, 2014.

OriginalsprogEngelsk
TidsskriftCritical Care
Vol/bind24
Udgave nummer1
Sider (fra-til)266
ISSN1466-609X
DOI
StatusUdgivet - 26 maj 2020

ID: 61293954