Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients
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Citações na Scopus
18
Tipo de produção
article
Data de publicação
2023
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER HEIDELBERG
Autores
Citação
JOURNAL OF CLINICAL MONITORING AND COMPUTING, v.37, n.3, p.753-760, 2023
Resumo
Analysis of intracranial pressure waveforms (ICPW) provides information on intracranial compliance. We aimed to assess the correlation between noninvasive ICPW (NICPW) and invasively measured intracranial pressure (ICP) and to assess the NICPW prognostic value in this population. In this cohort, acute brain-injured (ABI) patients were included within 5 days from admission in six Intensive Care Units. Mean ICP (mICP) values and the P2/P1 ratio derived from NICPW were analyzed and correlated with outcome, which was defined as: (a) early death (ED); survivors on spontaneous breathing (SB) or survivors on mechanical ventilation (MV) at 7 days from inclusion. Intracranial hypertension (IHT) was defined by ICP > 20 mmHg. A total of 72 patients were included (mean age 39, 68% TBI). mICP and P2/P1 values were significantly correlated (r = 0.49, p < 0.001). P2/P1 ratio was significantly higher in patients with IHT and had an area under the receiving operator curve (AUROC) to predict IHT of 0.88 (95% CI 0.78-0.98). mICP and P2/P1 ratio was also significantly higher for ED group (n = 10) than the other groups. The AUROC of P2/P1 to predict ED was 0.71 [95% CI 0.53-0.87], and the threshold P2/P1 > 1.2 showed a sensitivity of 60% [95% CI 31-83%] and a specificity of 69% [95% CI 57-79%]. Similar results were observed when decompressive craniectomy patients were excluded. In this study, P2/P1 derived from noninvasive ICPW assessment was well correlated with IHT. This information seems to be as associated with ABI patients outcomes as ICP.
Palavras-chave
Intracranial compliance, Intracranial pressure waveform, Intracranial hypertension, Acute brain injury, Neuromonitoring
Referências
- Andrade RDP, 2021, IEEE SENS J, V21, P22270, DOI 10.1109/JSEN.2021.3090648
- Battaglini D, 2020, FRONT NEUROL, V11, DOI 10.3389/fneur.2020.00845
- Bor-Seng-Shu E, 2013, NEUROSURG REV, V36, P361, DOI 10.1007/s10143-013-0453-2
- Brasil S, 2022, INTENS CARE MED, V48, P1667, DOI 10.1007/s00134-022-06855-2
- Brasil S, 2021, BRAIN SCI, V11, DOI 10.3390/brainsci11070874
- Brasil S, 2021, J PERS MED, V11, DOI 10.3390/jpm11121302
- Brasil S, 2021, BRAIN SCI, V11, DOI 10.3390/brainsci11080971
- Brasil S, 2021, OBES SCI PRACT, V7, P751, DOI 10.1002/osp4.534
- Citerio G, 2015, CURR OPIN CRIT CARE, V21, P113, DOI 10.1097/MCC.0000000000000179
- Czosnyka Marek, 2007, Neurosurg Focus, V22, pE10
- de Moraes FM, 2022, NEUROCRIT CARE, V37, P219, DOI 10.1007/s12028-022-01477-4
- Dhaese Thomas Markus, 2021, Surg Neurol Int, V12, P493, DOI 10.25259/SNI_124_2021
- Güiza F, 2015, INTENS CARE MED, V41, P1067, DOI 10.1007/s00134-015-3806-1
- Gura M, 2012, TURK NEUROSURG, V22, P411, DOI 10.5137/1019-5149.JTN.4201-11.1
- Jahns FP, 2019, CRIT CARE, V23, DOI 10.1186/s13054-019-2436-3
- Kazimierska A, 2021, ACTA NEUROCHIR, V163, P1979, DOI 10.1007/s00701-021-04834-y
- Langfitt T W, 1969, Clin Neurosurg, V16, P436
- Ballestero MFM, 2017, CHILD NERV SYST, V33, P1517, DOI 10.1007/s00381-017-3475-1
- March K, 2000, Crit Care Nurs Clin North Am, V12, P429
- MARMAROU A, 1975, J NEUROSURG, V43, P523, DOI 10.3171/jns.1975.43.5.0523
- Nucci CG, 2016, ACTA NEUROCHIR, V158, P581, DOI 10.1007/s00701-015-2672-5
- Ocamoto GN, 2021, FRONT NEUROL, V12, DOI 10.3389/fneur.2021.756112
- Okonkwo DO, 2017, CRIT CARE MED, V45, P1907, DOI 10.1097/CCM.0000000000002619
- Paraguassu G, 2021, FRONT NEUROSCI-SWITZ, V15, DOI 10.3389/fnins.2021.601945
- Rabelo Nicollas Nunes, 2021, Surg Neurol Int, V12, P274, DOI 10.25259/SNI_53_2021
- Rickli C, 2021, PLOS ONE, V16, DOI 10.1371/journal.pone.0240570
- Robba C, 2022, INTENS CARE MED, V48, P1812, DOI 10.1007/s00134-022-06899-4
- Robba C, 2021, LANCET NEUROL, V20, P548, DOI 10.1016/S1474-4422(21)00138-1
- Robba C, 2020, CRIT CARE, V24, DOI 10.1186/s13054-020-03105-z
- Robba C, 2019, INTENS CARE MED, V45, P1842, DOI 10.1007/s00134-019-05769-w
- Robin X, 2011, BMC BIOINFORMATICS, V12, DOI 10.1186/1471-2105-12-77
- Rubiano AM, 2022, CURR OPIN CRIT CARE, V28, P101, DOI 10.1097/MCC.0000000000000920
- Saba GT, 2021, BRAZ J ANESTHESIOL, V71, P656, DOI 10.1016/j.bjane.2021.09.003
- Torrecilla SG, 2021, HEARING RES, V408, DOI 10.1016/j.heares.2021.108312
- Wijdicks EFM, 2022, NEUROCRIT CARE, V36, P1022, DOI 10.1007/s12028-021-01438-3
- Xu GH, 2022, J CLIN NEUROSCI, V99, P261, DOI 10.1016/j.jocn.2022.03.011