Abstract
Objective: In a previous study, we observed the presence of simultaneous increases in intracranial pressure (ICP) and the heart rate (HR), which we denominated cardio-cerebral crosstalk (CC), and we related the number of such events to patient outcomes in a paediatric cohort. In this chapter, we present an extension of this work to an adult cohort from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study.
Methods: We implemented a sliding window algorithm to detect CC events. We considered subwindows of 10-min observations. If simultaneous increases of at least 20% in ICP and HR occurred with respect to the minimum ICP and HR values in the time windows, a CC event was detected. Correlation between the number of CC events and mortality was then obtained.
Results: The cohort consisted of 226 adults (aged 16–85 years). The number of CC events that were detected varied (mean 50, standard deviation 58). A point biserial correlation coefficient of −0.13 between mortality and CC was found. Although the correlation was weaker than that seen in the paediatric cohort (−0.30), the negative direction was replicated.
Conclusion: In this work, we first extracted CC events from ICP and HR observations of adult patients with traumatic brain injury and related the number of CC events to patient outcomes. Consistency with the previous results in the paediatric cohort was observed. The more crosstalk events occurred, the better the patient outcome was.
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Acknowledgments
This study was supported by a European Union Seventh Framework Program grant (number 602150) for the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.
CENTER-TBI High Resolution (HR ICU) Substudy Participants and Investigators: Audny Anke1, Ronny Beer2, Bo-Michael Bellander3, Andras Buki5, Manuel Cabeleira 6, Marco Carbonara 7, Arturo Chieregato4, Giuseppe Citerio8,9, Endre Czeiter10, Bart Depreitere11, Shirin Frisvold13, Raimund Helbok2, Stefan Jankowski14, Danile Kondziella15, Lars-Owe Koskinen16, Ana Kowark17, David K. Menon12, Geert Meyfroidt18, Kirsten Moeller19, David Nelson3, Anna Piippo-Karjalainen20, Andreea Radoi21, Arminas Ragauskas22, Rahul Raj20, Jonathan Rhodes23, Saulius Rocka22, Rolf Rossaint17, Juan Sahuquillo21, Oliver Sakowitz24,25, Nino Stocchetti 26, Nina Sundström27, Riikka Takala28, Tomas Tamosuitis29, Olli Tenovuo30, Peter Vajkoczy31, Alessia Vargiolu8, Rimantas Vilcinis32, Stefan Wolf33, Alexander Younsi25, Frederick A. Zeiler 12,34
1Department of Physical Medicine and Rehabilitation, University Hospital Northern Norway, Tromso, Norway
2Department of Neurology, Neurological Intensive Care Unit, Medical University of Innsbruck, Innsbruck, Austria
3Department of Neurosurgery & Anesthesia & Intensive Care Medicine, Karolinska University Hospital, Stockholm, Sweden
4NeuroIntensive Care, Niguarda Hospital, Milan, Italy
5Department of Neurosurgery, Medical School, University of Pécs; and Neurotrauma Research Group, János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
6Brain Physics Lab, Division of Neurosurgery, Dept of Clinical Neurosciences, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
7Neuro ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
8NeuroIntensive Care Unit, Department of Anesthesia & Intensive Care, ASST di Monza, Monza, Italy
9School of Medicine and Surgery, Università Milano Bicocca, Milano, Italy
10Department of Neurosurgery, University of Pécs; MTA-PTE Clinical Neuroscience MR Research Group and János Szentágothai Research Centre, University of Pécs; and Hungarian Brain Research Program (grant number KTIA 13 NAP-A-II/8), Pécs, Hungary
11Department of Neurosurgery, University Hospitals Leuven, Leuven, Belgium
12Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
13Department of Anesthesiology and Intensive Care, University Hospital Northern Norway, Tromso, Norway
14Neurointensive Care, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
15Departments of Neurology, Clinical Neurophysiology and Neuroanesthesiology, Region Hovedstaden Rigshospitalet, Copenhagen, Denmark
16Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå, Sweden
17Department of Anaesthesiology, University Hospital of Aachen, Aachen, Germany
18Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
19Department of Neuroanesthesiology, Region Hovedstaden Rigshospitalet, Copenhagen, Denmark
20Helsinki University Central Hospital, Helsinki, Finland
21Department of Neurosurgery, Vall d’Hebron University Hospital, Barcelona, Spain
22Department of Neurosurgery, Kaunas University of Technology and Vilnius University, Vilnius, Lithuania
23Department of Anaesthesia, Critical Care & Pain Medicine, NHS Lothian & University of Edinburgh, Edinburgh, UK
24Klinik für Neurochirurgie, Klinikum Ludwigsburg, Ludwigsburg, Germany
25Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
26Department of Pathophysiology and Transplantation, Milan University; and Neuroscience ICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
27Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden
28Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Central Hospital and University of Turku, Turku, Finland
29Neuro-intensive Care Unit, Kaunas University of Health Sciences, Kaunas, Lithuania
30Rehabilitation and Brain Trauma, Turku University Central Hospital and University of Turku, Turku, Finland
31Neurologie, Neurochirurgie und Psychiatrie, Charité – Universitätsmedizin Berlin, Berlin, Germany
32Department of Neurosurgery, Kaunas University of Health Sciences, Kaunas, Lithuania
33Department of Neurosurgery, Charité – Universitätsmedizin Berlin; corporate member of Freie Universität Berlin; Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany
34Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Dimitri, G.M. et al. (2021). Analysis of Cardio-Cerebral Crosstalk Events in an Adult Cohort from the CENTER-TBI Study. In: Depreitere, B., Meyfroidt, G., Güiza, F. (eds) Intracranial Pressure and Neuromonitoring XVII. Acta Neurochirurgica Supplement, vol 131. Springer, Cham. https://doi.org/10.1007/978-3-030-59436-7_9
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