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Systemic Markers of...
Systemic Markers of Injury and Injury Response are not Associated with Impaired Cerebrovascular Reactivity in Adult TBI : A CENTER-TBI Study
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Zeiler, Frederick Adam (författare)
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Mathieu, Francois (författare)
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Monteiro, Miguel Aires Barros (författare)
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Glocker, Ben (författare)
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Ercole, Ari (författare)
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Cabeleira, Manuel (författare)
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Stocchetti, Nino (författare)
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Smieleweski, Peter (författare)
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Czosnyka, Marek (författare)
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Newcombe, Virginia (författare)
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Menon, David (författare)
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- Koskinen, Lars-Owe D., Professor, 1955- (bidragsgivare)
- Umeå universitet,Institutionen för klinisk vetenskap,Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury High Resolution Intensive Care Unit Sub-Study Participants and Investigators
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- Sundström, Nina (författare)
- Umeå universitet,Institutionen för strålningsvetenskaper,Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury High Resolution Intensive Care Unit Sub-Study Participants and Investigators
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(creator_code:org_t)
- Mary Ann Liebert Inc. 2021
- 2021
- Engelska.
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Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert Inc.. - 0897-7151 .- 1557-9042. ; 38:7, s. 870-878
- Relaterad länk:
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https://www.reposito...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- The role of extra-cranial injury burden 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 CENTER-TBI HR ICU sub-study cohort, we evaluated those patients with both archived high-frequency digital intra-parenchymal ICP monitoring data of a minimum of 6 hours in duration, and the presence of a digital copy of their admission CT scan. Digital physiologic signals were processed for pressure reactivity index (PRx) and both the % time above defined PRx thresholds and mean hourly dose above threshold. This was conducted for both the first 72 hours 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 (IVH) 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-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 hours of recording, admission temperature (p=0.042) and white blood cell % (WBC %) (p=0.013) were statistically associated with impaired cerebrovascular reactivity on Mann-U and univariate logistic regression. After adjusting 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 do not appear to be strongly associated with impaired cerebrovascular reactivity in TBI, during both the initial and entire ICU stay. Keywords: autoregulation, cerebrovascular reactivity, extra-cranial injury, injury burden, TBI
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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Zeiler, Frederic ...
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Mathieu, Francoi ...
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Monteiro, Miguel ...
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Glocker, Ben
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Ercole, Ari
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Cabeleira, Manue ...
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visa fler...
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Stocchetti, Nino
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Smieleweski, Pet ...
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Czosnyka, Marek
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Newcombe, Virgin ...
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Menon, David
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Koskinen, Lars-O ...
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Sundström, Nina
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