Document Detail


Monitoring and interpretation of intracranial pressure after head injury.
MedLine Citation:
PMID:  16671437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Czosnyka; P J Hutchinson; M Balestreri; M Hiler; P Smielewski; J D Pickard
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  96     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2006  
Date Detail:
Created Date:  2006-05-04     Completed Date:  2006-06-12     Revised Date:  2014-02-19    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  114-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
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
Grant Support
ID/Acronym/Agency:
G0001237//Medical Research Council; G0601025//Medical Research Council

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


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