Neuroanesthesia & neurocritical care
Relationship between the shape of intracranial pressure pulse waveform and computed tomography characteristics in patients after traumatic brain injury
Authors' conclusion
ICP pulse shape reflects the reduction in cerebrospinal compensatory reserve related to space-occupying lesions despite comparable mean ICP and AmpICP levels.
Study context
- Population
- Traumatic brain injury (TBI) patients from the CENTER-TBI high-resolution sub-study with intracranial pressure (ICP) recordings and computed tomography (CT) scans
- Participants
- 130 patients
- Exposure
- Pulse shape index (PSI), mean ICP and amplitude of ICP (AmpICP) vs CT features
- Outcome
- Link between ICP pulse shape (PSI) and pathological CT features
- Follow-up
- First 24 h of ICP recording; first CT after admission
Methodological detailssecondary analysis of CENTER-TBI high-resolution sub-study, neural network classification of ICP pulses
- Secondary analysis of CENTER-TBI high-resolution sub-study
- Neural network classification of ICP pulses
Main finding
As reported in the abstract
PSI by CT features
With lesions
2.4
IQR 1.9–3.1
Without lesions
1.8
IQR 1.1–2.3
With midline shift
2.5
IQR 1.9–3.4
Without midline shift
1.8
IQR 1.2–2.4
With lesions vs Without lesions: P < < 0.001 · With midline shift vs Without midline shift: P < 0.001
Observational data: associations, not effects.
Further findings
Correlation of PSI with CT measures
- PSI significantly correlated with extent of midline shift, total lesion volume, Marshall and Rotterdam scores
Identification of pathological CT features (AUC)
- PSI AUCs
- > 0.7
- Mean ICP and AmpICP AUCs
- ≤ 0.6
Original publication
Relationship between the shape of intracranial pressure pulse waveform and computed tomography characteristics in patients after traumatic brain injury. Crit Care. Published 17 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →