Neuroanesthesia & neurocritical care
Evaluation of the prognostic value and modifiability of low-frequency pressure reactivity index in patients with traumatic brain injury
Authors' conclusion
Impaired cerebral autoregulation is associated with poor TBI outcomes. CPPopt has limited feasibility and inconsistent physiological correlation, which challenge its clinical utility.
Study context
- Population
- Moderate-to-severe traumatic brain injury (TBI) patients undergoing neurosurgery and intensive care unit (ICU) monitoring at two Taiwanese university hospitals (2022–2024)
- Participants
- 46 patients
- Exposure
- LPRx by 6-month survival and functional outcome
- Survivorsn = 35
- Favorable outcomen = 11
- Outcome
- Prognostic value of LPRx for 6-month clinical outcomes:
- Survival
- GOSE
- Follow-up
- 6 months
Methodological detailstwo-centre, minute-by-minute monitoring
- Two-centre
- Minute-by-minute monitoring
Main finding
As reported in the abstract
LPRx and 6-month outcome
- Higher median LPRx and greater proportion of time with LPRx > thresholds (e.g., > 0.3) correlated with unfavorable outcomes
- Early impaired LPRx (days 1, 3, 4) associated with unfavorable function
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Effect of decompressive craniectomy and osmotherapy on LPRx | P = 0.786 |
LPRx–intracranial pressure (ICP) relationship
- U-shaped relationship, nadir ∼10 mmHg
- 10 mmHg
CPPopt derivability
- CPPopt derivable in only this share of monitoring time, no consistent LPRx relationship
- 32%
Effect of decompressive craniectomy and osmotherapy on LPRx
- Decompressive craniectomy and osmotherapy did not significantly alter LPRx
Original publication
Evaluation of the prognostic value and modifiability of low-frequency pressure reactivity index in patients with traumatic brain injury. J Crit Care. Published 8 May 2026. doi:10.
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