Document Detail


Consistent changes in intracranial pressure waveform morphology induced by acute hypercapnic cerebral vasodilatation.
MedLine Citation:
PMID:  21052864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intracranial pressure (ICP) remains a pivotal physiological signal for managing brain injury and subarachnoid hemorrhage (SAH) patients in neurocritical care units. Given the vascular origin of the ICP, changes in ICP waveform morphology could be used to infer cerebrovascular changes. Clinical validation of this association in the setting of brain trauma, and SAH is challenging due to the multi-factorial influences on, and uncertainty of, the state of the cerebral vasculature.
METHODS: To gain a more controlled setting, in this articel, we study ICP signals recorded in four uninjured patients undergoing a CO2 inhalation challenge in which hypercapnia induced acute cerebral vasodilatation. We apply our morphological clustering and analysis of intracranial pressure (MOCAIP) algorithm to identify six landmarks on individual ICP pulses (based on the three established ICP sub-peaks; P1, P2, and P3) and extract 128 ICP morphological metrics. Then by comparing baseline, test, and post-test data, we assess the consistency and rate of change for each individual metric.
RESULTS: Acute vasodilatation causes consistent changes in a total of 72 ICP pulse morphological metrics and the P2 sub-region responds to cerebral vascular changes in the most consistent way with the greatest change as compared to P1 and P3 sub-regions.
CONCLUSIONS: Since the dilation/constriction of the cerebral vasculature resulted in detectable consistent changes in ICP MOCIAP metrics, by an extended monitoring practice of ICP that includes characterizing ICP pulse morphology, one can potentially detect cerebrovascular changes, continuously, for patients under neurocritical care.
Authors:
Shadnaz Asgari; Marvin Bergsneider; Robert Hamilton; Paul Vespa; Xiao Hu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Neurocritical care     Volume:  15     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-11     Completed Date:  2012-01-19     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  55-62     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Algorithms
Carbon Dioxide
Cerebrovascular Circulation / physiology*
Cluster Analysis
Cohort Studies
Dilatation, Pathologic / complications,  pathology,  physiopathology
Female
Humans
Hypercapnia / complications*,  pathology,  physiopathology*
Intracranial Pressure / physiology*
Middle Aged
Time Factors
Young Adult
Grant Support
ID/Acronym/Agency:
NS059797/NS/NINDS NIH HHS; R01 NS054881/NS/NINDS NIH HHS; R01 NS066008/NS/NINDS NIH HHS; R01 NS066008/NS/NINDS NIH HHS; R01 NS066008-02/NS/NINDS NIH HHS; R01 NS066008-03/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
142M471B3J/Carbon Dioxide
Comments/Corrections

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