Continuous monitoring of intracranial pressure and end tidal carbon dioxide variations in traumatic brain injury: introducing the carbon dioxide reactivity index (CO2Rx).
Authors' conclusion
CO2Rx demonstrated significant predictive value for mortality and unfavorable outcomes in TBI patients, serving as a continuous index of cerebrovascular reactivity to CO2.
Study context
- Population
- Adult and pediatric patients with severe traumatic brain injury (TBI)
- Participants
- 218 participants
- Exposure
- Pediatric vs Adult
- Pediatricn = 40
- Adultn = 178
- Outcome
- In-hospital mortality and Glasgow Outcome Scale-Extended (GOSE) score
- Follow-up
- 12 months (GOSE)
Methodological detailsprognostic index development, CO2Rx: linear correlation of intracranial pressure (ICP) and ETCO2 sampled at ≈5-min intervals, moving windows 40–180 min in 10-min increments
- Prognostic index development
- CO2Rx: linear correlation of ICP and ETCO2 sampled at ≈5-min intervals, moving windows 40–180 min in 10-min increments
Main finding
As reported in the abstract
Prediction of fatal/non-fatal outcome by CO2Rx (ROC analysis)
CO2Rx threshold distinguishing favorable vs unfavorable outcomes
0.28
AUC, CO2Rx crude model alone (fatal/non-fatal)
0.737
AUC, Impact Core + ICP + CO2Rx (highest)
0.929
Observational data: associations, not effects.
Original publication
Continuous monitoring of intracranial pressure and end tidal carbon dioxide variations in traumatic brain injury: introducing the carbon dioxide reactivity index (CO2Rx). J Clin Monit Comput. Published 22 March 2025. doi:10.
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