scholarly journals Transcranial Doppler Systolic Flow Index and ICP-Derived Cerebrovascular Reactivity Indices in Traumatic Brain Injury

2018 ◽  
Vol 35 (2) ◽  
pp. 314-322 ◽  
Author(s):  
Frederick A. Zeiler ◽  
Danilo Cardim ◽  
Joseph Donnelly ◽  
David K. Menon ◽  
Marek Czosnyka ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Transcranial Doppler ◽  
Cerebrovascular Reactivity ◽  
Flow Index ◽  
Reactivity Indices

scholarly journals P.186 Transcranial Doppler Based Continuous Assessment of Cerebrovascular Reactivity in Adult Traumatic Brain Injury: A Scoping Review of Associations with Outcomes

2021 ◽  
Vol 48 (s3) ◽  
pp. S73-S74
Author(s):  
A Gomez ◽  
L Froese ◽  
AS Sainbhi ◽  
C Batson ◽  
FA Zeiler
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Scoping Review ◽  
Time Domain ◽  
Transcranial Doppler ◽  
Continuous Time ◽  
Cerebrovascular Reactivity ◽  
Continuous Assessment ◽  
Physiologic Parameters ◽  
Carbon Dioxide Co2

Background: Disruption in cerebrovascular reactivity following traumatic brain injury (TBI) is a known phenomenon that may hold prognostic value. Transcranial Doppler (TCD) has been employed to evaluate cerebrovascular reactivity following injury utilizing a continuous time-series approach. Methods: A systematically conducted scoping review of the literature on the association of continuous time-domain TCD based indices of cerebrovascular reactivity, with outcomes following moderate and severe TBI was performed. Multiple databases were searched from inception to November 2020 for relevant articles. Results: Thirty-six relevant articles were identified. There was significant evidence supporting an association with continuous time-domain TCD based indices and functional outcomes following TBI. Physiologic parameters such as intracranial pressure, cerebral perfusion pressure, Carbon Dioxide (CO2) reactivity as well as more established indices of cerebrovascular reactivity have all been associated with these TCD based indices. The literature has been concentrated in a few centres and is further limited by the lack of multivariate analysis. Conclusions: There is a substantial body of evidence that cerebrovascular reactivity as measured by time-domain TCD based indices have prognostic utility following TBI. The literature supports some associations between these indices and cerebral physiologic parameters. Further validation in multi-institution studies is required before these indices can be widely adopted clinically.

Artifact removal from neurophysiological signals: impact on intracranial and arterial pressure monitoring in traumatic brain injury

2020 ◽  
Vol 132 (6) ◽  
pp. 1952-1960 ◽  
Author(s):  
Seung-Bo Lee ◽  
Hakseung Kim ◽  
Young-Tak Kim ◽  
Frederick A. Zeiler ◽  
Peter Smielewski ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Neurological Status ◽  
Cerebrovascular Reactivity ◽  
Cerebral Hypoperfusion ◽  
Clinical Parameters ◽  
Artifact Removal ◽  
Clinical Events ◽  
Arterial Blood ◽  
Before And After

OBJECTIVEMonitoring intracranial and arterial blood pressure (ICP and ABP, respectively) provides crucial information regarding the neurological status of patients with traumatic brain injury (TBI). However, these signals are often heavily affected by artifacts, which may significantly reduce the reliability of the clinical determinations derived from the signals. The goal of this work was to eliminate signal artifacts from continuous ICP and ABP monitoring via deep learning techniques and to assess the changes in the prognostic capacities of clinical parameters after artifact elimination.METHODSThe first 24 hours of monitoring ICP and ABP in a total of 309 patients with TBI was retrospectively analyzed. An artifact elimination model for ICP and ABP was constructed via a stacked convolutional autoencoder (SCAE) and convolutional neural network (CNN) with 10-fold cross-validation tests. The prevalence and prognostic capacity of ICP- and ABP-related clinical events were compared before and after artifact elimination.RESULTSThe proposed SCAE-CNN model exhibited reliable accuracy in eliminating ABP and ICP artifacts (net prediction rates of 97% and 94%, respectively). The prevalence of ICP- and ABP-related clinical events (i.e., systemic hypotension, intracranial hypertension, cerebral hypoperfusion, and poor cerebrovascular reactivity) all decreased significantly after artifact removal.CONCLUSIONSThe SCAE-CNN model can be reliably used to eliminate artifacts, which significantly improves the reliability and efficacy of ICP- and ABP-derived clinical parameters for prognostic determinations after TBI.

Critical Thresholds for Cerebrovascular Reactivity After Traumatic Brain Injury

2011 ◽  
Vol 16 (2) ◽  
pp. 258-266 ◽  
Author(s):  
E. Sorrentino ◽  
J. Diedler ◽  
M. Kasprowicz ◽  
K. P. Budohoski ◽  
C. Haubrich ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cerebrovascular Reactivity ◽  
Critical Thresholds

scholarly journals Experimental model of intracranial hypertension with continuous multiparametric monitoring in swine

2013 ◽  
Vol 71 (10) ◽  
pp. 802-806 ◽  
Author(s):  
Almir Ferreira de Andrade ◽  
Matheus Schmidt Soares ◽  
Gustavo Cartaxo Patriota ◽  
Alessandro Rodrigo Belon ◽  
Wellingson Silva Paiva ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Animal Model ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Severe Traumatic Brain Injury ◽  
Transcranial Doppler ◽  
Porcine Model ◽  
Cerebral Oximetry ◽  
Suitable Animal Model

Objective Intracranial hypertension (IH) develops in approximately 50% of all patients with severe traumatic brain injury (TBI). Therefore, it is very important to identify a suitable animal model to study and understand the pathophysiology of refractory IH to develop effective treatments. Methods We describe a new experimental porcine model designed to simulate expansive brain hematoma causing IH. Under anesthesia, IH was simulated with a balloon insufflation. The IH variables were measured with intracranial pressure (ICP) parenchymal monitoring, epidural, cerebral oximetry, and transcranial Doppler (TCD). Results None of the animals died during the experiment. The ICP epidural showed a slower rise compared with parenchymal ICP. We found a correlation between ICP and cerebral oximetry. Conclusion The model described here seems useful to understand some of the pathophysiological characteristics of acute IH.

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