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

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Harvard

Riemann, L, Beqiri, E, Smielewski, P, Czosnyka, M, Stocchetti, N, Sakowitz, O, Zweckberger, K, Unterberg, A, Younsi, A, CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators, Kondziella, D & Møller, K 2020, 'Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury: a CENTER-TBI study', Critical Care, vol. 24, no. 1, pp. 266. https://doi.org/10.1186/s13054-020-02974-8

APA

Riemann, L., Beqiri, E., Smielewski, P., Czosnyka, M., Stocchetti, N., Sakowitz, O., Zweckberger, K., Unterberg, A., Younsi, A., CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators, Kondziella, D., & Møller, K. (2020). Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury: a CENTER-TBI study. Critical Care, 24(1), 266. https://doi.org/10.1186/s13054-020-02974-8

CBE

Riemann L, Beqiri E, Smielewski P, Czosnyka M, Stocchetti N, Sakowitz O, Zweckberger K, Unterberg A, Younsi A, CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators, Kondziella D, Møller K. 2020. Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury: a CENTER-TBI study. Critical Care. 24(1):266. https://doi.org/10.1186/s13054-020-02974-8

MLA

Vancouver

Author

Riemann, Lennart ; Beqiri, Erta ; Smielewski, Peter ; Czosnyka, Marek ; Stocchetti, Nino ; Sakowitz, Oliver ; Zweckberger, Klaus ; Unterberg, Andreas ; Younsi, Alexander ; CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators ; Kondziella, Daniel ; Møller, Kirsten. / Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury : a CENTER-TBI study. In: Critical Care. 2020 ; Vol. 24, No. 1. pp. 266.

Bibtex

@article{5a49f9b18b03401b96ccc70b58aff488,
title = "Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury: a CENTER-TBI study",
abstract = "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.",
author = "Lennart Riemann and Erta Beqiri and Peter Smielewski and Marek Czosnyka and Nino Stocchetti and Oliver Sakowitz and Klaus Zweckberger and Andreas Unterberg and Alexander Younsi and {CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators} and Daniel Kondziella and Kirsten M{\o}ller",
year = "2020",
month = may,
day = "26",
doi = "10.1186/s13054-020-02974-8",
language = "English",
volume = "24",
pages = "266",
journal = "Critical Care",
issn = "1466-609X",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Low-resolution pressure reactivity index and its derived optimal cerebral perfusion pressure in adult traumatic brain injury

T2 - a CENTER-TBI study

AU - Riemann, Lennart

AU - Beqiri, Erta

AU - Smielewski, Peter

AU - Czosnyka, Marek

AU - Stocchetti, Nino

AU - Sakowitz, Oliver

AU - Zweckberger, Klaus

AU - Unterberg, Andreas

AU - Younsi, Alexander

AU - CENTER-TBI High Resolution ICU (HR ICU) Sub-Study Participants and Investigators

A2 - Kondziella, Daniel

A2 - Møller, Kirsten

PY - 2020/5/26

Y1 - 2020/5/26

N2 - 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.

AB - 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.

U2 - 10.1186/s13054-020-02974-8

DO - 10.1186/s13054-020-02974-8

M3 - Journal article

C2 - 32456684

VL - 24

SP - 266

JO - Critical Care

JF - Critical Care

SN - 1466-609X

IS - 1

ER -

ID: 61293954