Document Detail


Evaluation of the cerebrovascular pressure reactivity index using non-invasive finapres arterial blood pressure.
MedLine Citation:
PMID:  20664157     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A pressure reactivity index (PRx) can be assessed in patients with continuous monitoring of arterial blood pressure (ABP) and intracranial pressure (ICP) as a moving correlation coefficient between slow fluctuations of these two signals within a low frequency bandwidth. The study aimed to investigate whether the invasive ABP monitoring can be replaced with non-invasive measurement of ABP using a Finapres plethysmograph (fABP) to calculate the fPRx. There is a well-defined group of patients, suffering from hydrocephalus and undergoing CSF pressure monitoring, which may benefit from such a measurement. 41 simultaneous day-by-day monitoring of ICP, ABP and fABP were performed for about 30 min in 10 head injury patients. A Bland-Altman assessment for agreement was used to compare PRx and fPRx calculations. Performance metrics and the McNemary test were used to determine whether fPRx is sensitive enough to distinguish between functioning and disturbed cerebrovascular pressure reactivity. The fPRx correlated with PRx (R(Spearman) = 0.92, p < 0.001; bias = -0.04; lower and upper limits of agreement: -0.26 and 0.17, respectively). The fPRx distinguished between active and passive reactivity in more than 89% cases. The fPRx can be used with care for assessment of cerebrovascular reactivity in patients for whom invasive ABP measurement is not feasible. The fPRx is sensitive enough to distinguish between functional and deranged reactivity.
Authors:
M Kasprowicz; E Schmidt; D J Kim; C Haubrich; Z Czosnyka; P Smielewski; M Czosnyka
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-28
Journal Detail:
Title:  Physiological measurement     Volume:  31     ISSN:  1361-6579     ISO Abbreviation:  Physiol Meas     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-12     Completed Date:  2011-01-21     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  9306921     Medline TA:  Physiol Meas     Country:  England    
Other Details:
Languages:  eng     Pagination:  1217-28     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Arteries
Blood Pressure*
Brain / blood supply*,  physiology*
Humans
Intracranial Pressure*
Plethysmography / methods*
Grant Support
ID/Acronym/Agency:
G9439390//Medical Research Council

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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