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Erschienen in: Intensive Care Medicine 6/2012

01.06.2012 | Physiological and Technical Notes

An evaluation of three measures of intracranial compliance in traumatic brain injury patients

verfasst von: Tim Howells, Anders Lewén, Mattias K. Sköld, Elisabeth Ronne-Engström, Per Enblad

Erschienen in: Intensive Care Medicine | Ausgabe 6/2012

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Abstract

Purpose

To compare intracranial pressure (ICP) amplitude, ICP slope, and the correlation of ICP amplitude and ICP mean (RAP index) as measures of compliance in a cohort of traumatic brain injury (TBI) patients.

Methods

Mean values of the three measures were calculated in the 2-h periods before and after surgery (craniectomies and evacuations), and in the 12-h periods preceding and following thiopental treatment, and during periods of thiopental coma. The changes in the metrics were evaluated using the Wilcoxon test. The correlations of 10-day mean values for the three metrics with age, admission Glasgow Motor Score (GMS), and Extended Glasgow Outcome Score (GOSe) were evaluated. Patients under and over 60 years old were also compared using the Student t test. The correlation of ICP amplitude with systemic pulse amplitude was analyzed.

Results

ICP amplitude was significantly correlated with GMS, and also with age for patients 35 years old and older. The correlations of ICP slope and the RAP index with GMS and with age were not significant. All three metrics indicated significant improvements in compliance following surgery and during thiopental coma. None of the metrics were significantly correlated with outcome, possibly due to confounding effects of treatment factors. The correlation of systemic pulse amplitude with ICP amplitude was low (R = 0.18), only explaining 3 % of the variance.

Conclusions

This study provides further validation for all three of these features of the ICP waveform as measures of compliance. ICP amplitude had the best performance in these tests.
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Metadaten
Titel
An evaluation of three measures of intracranial compliance in traumatic brain injury patients
verfasst von
Tim Howells
Anders Lewén
Mattias K. Sköld
Elisabeth Ronne-Engström
Per Enblad
Publikationsdatum
01.06.2012
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2012
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-012-2571-7

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