Neuroanesthesia & neurocritical care
Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients
Authors' conclusion
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.
Study context
- Population
- Acute brain-injured patients included within 5 days from admission in six ICUs68% TBI
- Participants
- 72 patients
- Exposure
- Early death (ED) vs spontaneous breathing (SB) vs mechanical ventilation (MV)
- EDn = 10
- Outcome
- Correlation between noninvasive intracranial pressure (ICP) waveforms (P2/P1 ratio) and invasively measured ICP; prognostic value for outcome
- Follow-up
- 7 days from inclusion
Methodological detailssix ICUs
- Six ICUs
Main finding
As reported in the abstract
Correlation of mICP and P2/P1; P2/P1 for IHT (ICP > 20 mmHg)
Correlation Mean ICP (mICP) vs P2/P1 (r)
0.49
p < 0.001
Area under the receiving operator curve (AUROC) of P2/P1 to predict intracranial hypertension (IHT)
0.88
95% CI 0.78–0.98
Observational data: associations, not effects.
Further findings
Prediction of early death by P2/P1 · 7 days from inclusion
- AUROC of P2/P1 to predict ED
- 0.71 (95% CI 0.53-0.87)
- Sensitivity of P2/P1 > 1.2
- 60% (95% CI 31-83%)
- Specificity of P2/P1 > 1.2
- 69% (95% CI 57-79%)
- mICP and P2/P1 significantly higher in ED than other groups
- Similar results excluding decompressive craniectomy patients
Original publication
Noninvasive intracranial pressure waveforms for estimation of intracranial hypertension and outcome prediction in acute brain-injured patients. J Clin Monit Comput. Published 18 November 2022. doi:10.
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