Neuroanesthesia & neurocritical care
Visualization of Cerebral Pressure Autoregulatory Insults in Traumatic Brain Injury*
Authors' conclusion
Higher intensities for longer durations of positive PRx and negative ∆CPPopt correlated with worse outcome. Elevated ICP, low CPP, and negative ∆CPPopt were particularly associated with worse outcomes when the cerebral pressure autoregulation was concurrently impaired.
Study context
- Population
- TBI patients with intracranial pressure (ICP) and arterial BP monitoring and 6-month GOS outcome data, neurocritical care unit, Cambridge, UK
- Participants
- 553 patients
- Outcome
- Combined effect of insult intensity and duration of PRx and ∆CPPopt (actual CPP − optimal CPP) on outcome (GOS)
- Follow-up
- 6 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Insult intensity and duration of PRx and ∆CPPopt vs GOS (heatmaps)
- Transition from favorable to unfavorable outcome when PRx remained positive for 30 minutes, and for shorter durations at higher intensity
- Gradual transition from favorable to unfavorable outcome when ∆CPPopt went below −5 mm Hg for 30-minute episodes, and for shorter durations for more negative ∆CPPopt
Observational data: associations, not effects.
Further findings
Combined PRx/ICP heatmap (% monitoring time)
- ICP above 20 mm Hg together with PRx above 0 correlated with unfavorable outcome
Combined PRx/CPP heatmap (% monitoring time)
- CPP below 70 mm Hg together with PRx above 0.2-0.4 correlated with unfavorable outcome
Combined PRx/∆CPPopt heatmap (% monitoring time)
- ∆CPPopt below 0 together with PRx above 0.2-0.4 correlated with unfavorable outcome
Original publication
Visualization of Cerebral Pressure Autoregulatory Insults in Traumatic Brain Injury*. Crit Care Med. Published 8 April 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →