Abstract
We previously showed that the flow-ICP index (Fix), a moving correlation coefficient between intracranial pressure (ICP) and cerebral blood flow velocity (CBFV), had marginally greater prognostic value for patients with traumatic brain injury (TBI) than an index of cerebral autoregulation (mean index, Mx). The aim of this study was to further examine the clinical and physiological relevance of Fix by studying its behaviour during ICP plateau waves in patients with TBI. Twenty-nine recordings of CBFV made during ICP plateau waves were analysed. Both Mx and Fix at baseline and peak ICP were significantly different, although the magnitude of Fix change was slightly greater. The correlation between Fix and cerebral perfusion pressure (CPP) was stronger than that between Mx and CPP. Unlike in our previous study, plotting Fix against CPP revealed a peak value in the range of “optimal” CPP, as indicated by the Mx versus CPP plot. The findings suggest that during periods of reduced CPP caused by plateau waves, the dynamic behaviour of Fix is similar to that of a measure of cerebral autoregulation. This conclusion needs to be verified against similar results obtained during episodes of supranormal CPP.
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Auer LM, Sayama I (1983) Intracranial pressure oscillations (B-waves) caused by oscillations in cerebrovascular volume. Acta Neurochir (Wien) 68(1–2):93–100
Budohoski KP, Czosnyka M, de Riva N, Smielewski P, Pickard JD, Menon DK, Kirkpatrick PJ, Lavinio A (2012) The relationship between cerebral blood flow autoregulation and cerebrovascular pressure reactivity after traumatic brain injury. Neurosurgery 71(3):652–660; discussion 660–651
Castellani G, Zweifel C, Kim DJ, Carrera E, Radolovich DK, Smielewski P, Hutchinson PJ, Pickard JD, Czosnyka M (2009) Plateau waves in head injured patients requiring neurocritical care. Neurocrit Care 11(2):143–150
Czosnyka M, Smielewski P, Piechnik S, Pickard JD (2002) Clinical significance of cerebral autoregulation. Acta Neurochir Suppl 81:117–119
Goh D, Minns RA, Pye SD, Steers AJ (1992) Cerebral blood-flow velocity and intermittent intracranial pressure elevation during sleep in hydrocephalic children. Dev Med Child Neurol 34(8):676–689
Lang EW, Lagopoulos J, Griffith J, Yip K, Mudaliar Y, Mehdorn HM, Dorsch NW (2003) Noninvasive cerebrovascular autoregulation assessment in traumatic brain injury: validation and utility. J Neurotrauma 20(1):69–75
Lewis PM, Smielewski P, Pickard JD, Czosnyka M (2007) Dynamic cerebral autoregulation: should intracranial pressure be taken into account? Acta Neurochir (Wien) 149(6):549–555; discussion 555
Lewis PM, Smielewski P, Rosenfeld JV, Pickard JD, Czosnyka M (2012) Monitoring of the association between cerebral blood flow velocity and intracranial pressure. Acta Neurochir Suppl 114:147–151
Newell DW, Aaslid R, Stooss R, Reulen HJ (1992) The relationship of blood flow velocity fluctuations to intracranial pressure B waves. J Neurosurg 76(3):415–421
Lewis PM, Smielewski P, Rosenfeld JV, Pickard JD, Czosnyka M (2014) A continuous correlation between intracranial pressure and cerebral blood flow velocity reflects cerebral autoregulation impairment during intracranial pressure plateau waves. Neurocrit Care 21(3):514–525
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MC and PS have a financial interest in part of the licensing fee for ICM+. None of the other authors have any conflicts of interest to disclose.
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Lewis, P.M., Smielewski, P., Rosenfeld, J.V., Pickard, J.D., Czosnyka, M. (2016). The Correlation Between Intracranial Pressure and Cerebral Blood Flow Velocity During ICP Plateau Waves. In: Ang, BT. (eds) Intracranial Pressure and Brain Monitoring XV. Acta Neurochirurgica Supplement, vol 122. Springer, Cham. https://doi.org/10.1007/978-3-319-22533-3_16
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DOI: https://doi.org/10.1007/978-3-319-22533-3_16
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