scholarly journals Critical Thresholds of Intracranial Pressure-Derived Continuous Cerebrovascular Reactivity Indices for Outcome Prediction in Noncraniectomized Patients with Traumatic Brain Injury

2018 ◽  
Vol 35 (10) ◽  
pp. 1107-1115 ◽  
Author(s):  
Frederick A. Zeiler ◽  
Joseph Donnelly ◽  
Peter Smielewski ◽  
David K. Menon ◽  
Peter J. Hutchinson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Outcome Prediction ◽  
Cerebrovascular Reactivity ◽  
Critical Thresholds ◽  
Reactivity Indices

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 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

Alternative continuous intracranial pressure-derived cerebrovascular reactivity metrics in traumatic brain injury: a scoping overview

2020 ◽  
Vol 162 (7) ◽  
pp. 1647-1662
Author(s):  
Mohammed Hasen ◽  
Alwyn Gomez ◽  
Logan Froese ◽  
Joshua Dian ◽  
Rahul Raj ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Cerebrovascular Reactivity

scholarly journals Critical thresholds for intracranial pressure vary over time in non-craniectomised traumatic brain injury patients

2018 ◽  
Vol 160 (7) ◽  
pp. 1315-1324 ◽  
Author(s):  
Basil Nourallah ◽  
Frederick A. Zeiler ◽  
Leanne Calviello ◽  
Peter Smielewski ◽  
Marek Czosnyka ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Critical Thresholds ◽  
Over Time

scholarly journals Descriptive analysis of low versus elevated intracranial pressure on cerebral physiology in adult traumatic brain injury: a CENTER-TBI exploratory study

2020 ◽  
Vol 162 (11) ◽  
pp. 2695-2706
Author(s):  
Frederick A. Zeiler ◽  
◽  
Ari Ercole ◽  
Manuel Cabeleira ◽  
Nino Stocchetti ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Brain Tissue ◽  
Pulse Amplitude ◽  
Cerebrovascular Reactivity ◽  
Study Cohort ◽  
Elevated Intracranial Pressure ◽  
Brain Tissue Oxygenation ◽  
Compensatory Reserve

Abstract Background To date, the cerebral physiologic consequences of persistently elevated intracranial pressure (ICP) have been based on either low-resolution physiologic data or retrospective high-frequency data from single centers. The goal of this study was to provide a descriptive multi-center analysis of the cerebral physiologic consequences of ICP, comparing those with normal ICP to those with elevated ICP. Methods The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) High-Resolution Intensive Care Unit (HR-ICU) sub-study cohort was utilized. The first 3 days of physiologic recording were analyzed, evaluating and comparing those patients with mean ICP < 15 mmHg versus those with mean ICP > 20 mmHg. Various cerebral physiologic parameters were derived and evaluated, including ICP, brain tissue oxygen (PbtO2), cerebral perfusion pressure (CPP), pulse amplitude of ICP (AMP), cerebrovascular reactivity, and cerebral compensatory reserve. The percentage time and dose above/below thresholds were also assessed. Basic descriptive statistics were employed in comparing the two cohorts. Results 185 patients were included, with 157 displaying a mean ICP below 15 mmHg and 28 having a mean ICP above 20 mmHg. For admission demographics, only admission Marshall and Rotterdam CT scores were statistically different between groups (p = 0.017 and p = 0.030, respectively). The high ICP group displayed statistically worse CPP, PbtO2, cerebrovascular reactivity, and compensatory reserve. The high ICP group displayed worse 6-month mortality (p < 0.0001) and poor outcome (p = 0.014), based on the Extended Glasgow Outcome Score. Conclusions Low versus high ICP during the first 72 h after moderate/severe TBI is associated with significant disparities in CPP, AMP, cerebrovascular reactivity, cerebral compensatory reserve, and brain tissue oxygenation metrics. Such ICP extremes appear to be strongly related to 6-month patient outcomes, in keeping with previous literature. This work provides multi-center validation for previously described single-center retrospective results.

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