| Monitoring and interpretation of intracranial pressure after head injury. | |
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MedLine Citation:
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PMID: 16671437 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the relationships between long-term computer-assisted monitoring of intracranial pressure (ICP) and indices derived from its waveform versus outcome, age, and sex. MATERIALS AND METHODS: From 1992 to 2002, 429 sedated and ventilated head-injured patients were continuously monitored. ICP and arterial blood pressure (ABP) were recorded directly and stored in bedside computers. Additional calculated variables included: 1) Cerebral perfusion pressure (CPP) = ABP - ICP; 2) a PRx calculated as a moving correlation coefficient between slow waves (of periods from 20 seconds to 3 minutes) of ICP and ABP. RESULTS: Fatal outcome was associated with higher ICP (p < 0.000002), worse PRx (p < 0.0006), and lower CPP (p < 0.001). None of these parameters differentiated severely disabled patients from patients with a favorable outcome. Higher average ICP, lower CPP, worse outcome, and worse pressure reactivity were observed in females than in males (age-matched). Worse outcome, lower mean ICP, worse PRx, and higher CPP were significantly associated with the older age of patients. CONCLUSION: High ICP and low PRx are strongly associated with fatal outcome. There is a considerable heterogeneity amongst patients; optimization of care depends upon observing the time-trends for the individual patient. |
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Authors:
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M Czosnyka; P J Hutchinson; M Balestreri; M Hiler; P Smielewski; J D Pickard |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Acta neurochirurgica. Supplement Volume: 96 ISSN: 0065-1419 ISO Abbreviation: Acta Neurochir. Suppl. Publication Date: 2006 |
Date Detail:
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Created Date: 2006-05-04 Completed Date: 2006-06-12 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100962752 Medline TA: Acta Neurochir Suppl Country: Austria |
Other Details:
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Languages: eng Pagination: 114-8 Citation Subset: IM |
Affiliation:
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Department of Clinical Neurosciences, Neurosurgical Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. Mc141@medschl.cam.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Brain Injuries / diagnosis*, mortality* Comorbidity Diagnosis, Computer-Assisted / methods* Great Britain / epidemiology Humans Intracranial Hypertension / diagnosis*, mortality* Intracranial Pressure* Manometry / methods, statistics & numerical data* Monitoring, Physiologic / methods, statistics & numerical data Prognosis Reproducibility of Results Retrospective Studies Risk Assessment / methods Risk Factors Sensitivity and Specificity Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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