Derangement of Cerebral Blood Flow Autoregulation During Intracranial Pressure Plateau Waves as Detected by Time and Frequency-Based Methods.
Acta Neurochir Suppl
; 122: 233-8, 2016.
Article
em En
| MEDLINE
| ID: mdl-27165913
ABSTRACT
Plateau waves are sudden elevations of intracranial pressure (ICP) above 40 mmHg, lasting at least 5 min, and are associated with cerebral vasodilatation. We studied the performance of several parameters for cerebral autoregulation assessment during 30 plateau waves of 24 patients with traumatic brain injury. Continuous signals were collected for ICP, arterial blood pressure (ABP) and transcranial Doppler flow velocity (FV). Parameters both in the time domain (autoregulation index, ARI and mean flow index, Mx) and the frequency domain (transfer function gain, phase and coherence) were analysed. The role of different inputs, using either ABP or cerebral perfusion pressure (CPP) as input, was also tested.Autoregulation deteriorated from baseline to plateau, which could be demonstrated by a significant decrease in both ARI between ABP and FV (p = 0.013) and ARI between CPP and FV (p = 0.014). There was also a significant increase in Mx between CPP and FV (p = 0.004), but not in Mx between ABP and FV (p = 0.472). From the baseline to plateau, there was a significant increase in coherence between the ABP and FV at the very low frequency (p = 0.004). The transfer function phase and gain, on the other hand, revealed inconsistent performance.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Circulação Cerebrovascular
/
Hipertensão Intracraniana
/
Lesões Encefálicas Traumáticas
/
Homeostase
Tipo de estudo:
Etiology_studies
Limite:
Humans
Idioma:
En
Revista:
Acta Neurochir Suppl
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Reino Unido