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

Systemic Markers of Injury and Injury Response Are Not Associated with Impaired Cerebrovascular Reactivity in Adult Traumatic Brain Injury: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Training non-intensivist doctors to work with COVID-19 patients in intensive care units

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Prediction of survival in amyotrophic lateral sclerosis: a nationwide, Danish cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Frederick A Zeiler
  • François Mathieu
  • Miguel Monteiro
  • Ben Glocker
  • Ari Ercole
  • Manuel Cabeleira
  • Nino Stocchetti
  • Peter Smielewski
  • Marek Czosnyka
  • Virginia Newcombe
  • David K Menon
  • Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (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

The role of extra-cranial injury burden and systemic injury response on cerebrovascular response in traumatic brain injury (TBI) is poorly documented. This study preliminarily assesses the association between admission features of extra-cranial injury burden on cerebrovascular reactivity. Using the Collaborative European Neurotrauma Effectiveness Research in TBI High-Resolution ICU (HR ICU) sub-study cohort, we evaluated those patients with both archived high-frequency digital intra-parenchymal intra-cranial pressure monitoring data of a minimum of 6 h in duration, and the presence of a digital copy of their admission computed tomography (CT) scan. Digital physiologic signals were processed for pressure reactivity index (PRx) and both the percent time above defined PRx thresholds and mean hourly dose above threshold. This was conducted for both the first 72 h and entire duration of recording. Admission extra-cranial injury characteristics and CT injury scores were obtained from the database, with quantitative contusion, edema, intraventricular hemorrhage, and extra-axial lesion volumes were obtained via semi-automated segmentation. Comparison between admission extra-cranial markers of injury and PRx metrics was conducted using Mann-Whitney U testing, and logistic regression techniques, adjusting for known CT injury metrics associated with impaired PRx. A total of 165 patients were included. Evaluating the entire ICU recording period, there was limited association between metrics of extra-cranial injury burden and impaired cerebrovascular reactivity. Using the first 72 h of recording, admission temperature (p = 0.042) and white blood cell % (WBC %; p = 0.013) were statistically associated with impaired cerebrovascular reactivity on Mann-Whitney U and univariate logistic regression. After adjustment for admission age, pupillary status, GCS motor score, pre-hospital hypoxia/hypotension, and intra-cranial CT characteristics associated with impaired reactivity, temperature (p = 0.021) and WBC % (p = 0.013) remained significantly associated with mean PRx values above +0.25 and +0.35, respectively. Markers of extra-cranial injury burden and systemic injury response do not appear to be strongly associated with impaired cerebrovascular reactivity in TBI during both the initial and entire ICU stay.

OriginalsprogEngelsk
TidsskriftJournal of Neurotrauma
Vol/bind38
Udgave nummer7
Sider (fra-til)870-878
Antal sider9
ISSN0897-7151
DOI
StatusUdgivet - 1 apr. 2021

ID: 62370576