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Statistical cerebro...
Statistical cerebrovascular reactivity signal properties after secondary decompressive craniectomy in traumatic brain injury : a CENTER-TBI pilot analysis
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- Zeiler, Frederick Adam (författare)
- Division of Anesthesia, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada; Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, Manitoba, Canada; Centre on Aging, University of Manitoba, Winnipeg, Manitoba, Canada
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- Aries, Marcel (författare)
- Department of Intensive Care, Maastricht UMC, Maastricht, The Netherlands
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- Cabeleira, Manuel (författare)
- Brain Physics Laboratory, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- van Essen, Thomas (författare)
- University Neurosurgical Center Holland, Department of Neurosurgery, Leiden University Medical Center and Haaglanden Medical Center, Leiden and The Hague, The Netherlands
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- Stocchetti, Nino (författare)
- Neuro ICU Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Physiopathology and Transplantation, Milan University, Milan, Italy
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- Menon, David (författare)
- Division of Anesthesia, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- Timofeev, Ivan (författare)
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- Czosnyka, Marek (författare)
- Brain Physics Laboratory, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom; Institute of Electronic Systems, Warsaw University of Technology, Warsaw, Poland
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- Smieleweski, Peter (författare)
- Brain Physics Laboratory, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- Hutchinson, Peter John (författare)
- Department of Clinical Neurosciences, Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- Ercole, Ari (författare)
- Division of Anesthesia, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
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- Koskinen, Lars-Owe D., Professor, 1955- (bidragsgivare)
- Umeå universitet,Neurovetenskaper,CENTER-TBI
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(creator_code:org_t)
- Mary Ann Liebert, 2020
- 2020
- Engelska.
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Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 37:11, s. 1306-1314
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Abstract
Ämnesord
Stäng
- Decompressive craniectomy (DC) in traumatic brain injury (TBI) has been suggested to influence cerebrovascular reactivity. We aimed to determine if the statistical properties of vascular reactivity metrics and slow-wave relationships were impacted after DC, as such information would allow us to comment on whether vascular reactivity monitoring remains reliable after craniectomy. Using the CENTER-TBI high-resolution intensive care unit (ICU) cohort, we selected those secondary DC patients with high-frequency physiologic data for both: at least 24 hours before DC, and more than 48 hours post-DC. Data for all physiology measures was separated into: the 24 hours before DC, the first 48 hours post DC, and beyond 48 hours post-DC. We produced slow-wave data sheets for intra-cranial pressure (ICP) and mean arterial pressure (MAP) per patient. We also derived pressure reactivity index (PRx) as continuous cerebrovascular reactivity metrics updated every minute. The time-series behavior of PRx was modeled for each time period per patient. Finally, the relationship between ICP and MAP during these 3 time periods was assessed using time-series vector autoregressive integrative moving average (VARIMA) models, impulse response function (IRF) plots, and Granger causality testing. Ten patients were included in this study. Mean PRx and proportion of time above PRx thresholds were not affected by craniectomy. Similarly, PRx time-series structure was not affected by DC, when assessed in each individual patient. This was confirmed with Granger causality testing, and VARIMA IRF plotting for the MAP/ICP slow-wave relationship. PRx metrics and statistical time-series behavior appears not to be substantially influenced by DC. Similarly, there is little change in the relationship between slow-waves of ICP and MAP before and after DC. This may suggest that cerebrovascular reactivity monitoring in the setting of DC may still provide valuable information regarding autoregulation.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Adult brain injury
- Blood flow
- CFB autoregulation
- Traumatic brain injury
- cerebrovascular reactivity
- decompressive craniectomy
- DC
- PRx
- TBI
- neurokirurgi
- Neurosurgery
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Zeiler, Frederic ...
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Aries, Marcel
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Cabeleira, Manue ...
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van Essen, Thoma ...
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Stocchetti, Nino
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Menon, David
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Timofeev, Ivan
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Czosnyka, Marek
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Smieleweski, Pet ...
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Hutchinson, Pete ...
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Ercole, Ari
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Koskinen, Lars-O ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Neurologi
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Journal of Neuro ...
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Umeå universitet
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Karolinska Institutet