Aboy M, McNames J, Wakeland W, Goldstein B
Biomedical Signal Processing Laboratory, Department of Electrical and Computer Engineering at Portland State University, Portland, OR, USA.
Acta Neurochir Suppl. 2005;95:307-10. doi: 10.1007/3-211-32318-x_63.
We investigated the relationship between the intracranial pulse pressure (ICPpp) and the mean intracranial pressure (ICP(M)) in pediatric patients with traumatic brain injury (TBI).
We screened ICP records of 42 patients admitted to the Pediatric Intensive Care Unit at Doernbecher Children's Hospital (OHSU) for segments in which the ICPM varied at least 5 mmHg. We found 54 ICP segments in 9 pediatric TBI patients (ages 0.2-17.8 years, mean = 9.9). ICP was continuously monitored (fs = 125 Hz). We used an automatic algorithm to detect ICP beat components. We then calculated the ICPpp and ICPM for each beat and created density plots of ICPpp vs. ICPM.
The coefficient of linear correlation was r > 0.70 in 43/54 segments (p < 0.01). We found that an underlying linear relationship exits between ICPpp and ICPM in most 1-hour records of pediatric patients with TBI. This finding is consistent with the data in adult studies, suggesting that children with TBI demonstrate similar changes in brain compliance. However, density plots revealed that there are also nonlinear ICPpp-ICPM patterns present that are not captured by linear metrics.
Although there is an underlying linear relationship between ICPpp and ICPM, nonlinear patterns are also present. Further research is required to determine if specific nonlinear ICPpp-ICPM patterns correlate with clinically significant information.
我们研究了创伤性脑损伤（TBI）患儿的颅内脉压（ICPpp）与平均颅内压（ICP(M)）之间的关系。
我们筛选了俄勒冈健康与科学大学多恩贝彻儿童医院儿科重症监护病房收治的42例患者的颅内压记录，以找出ICP(M)变化至少5 mmHg的时间段。我们在9例儿科TBI患者（年龄0.2 - 17.8岁，平均9.9岁）中发现了54个颅内压时间段。颅内压进行连续监测（采样频率fs = 125 Hz）。我们使用自动算法检测颅内压搏动成分。然后我们计算每个搏动的ICPpp和ICP(M)，并创建ICPpp与ICP(M)的密度图。
在54个时间段中的43个（p < 0.01），线性相关系数r > 0.70。我们发现在大多数儿科TBI患者1小时的记录中，ICPpp和ICP(M)之间存在潜在的线性关系。这一发现与成人研究的数据一致，表明TBI患儿在脑顺应性方面表现出类似的变化。然而，密度图显示也存在线性指标未捕捉到的非线性ICPpp - ICP(M)模式。
虽然ICPpp和ICP(M)之间存在潜在的线性关系，但非线性模式也存在。需要进一步研究以确定特定的非线性ICPpp - ICP(M)模式是否与临床重要信息相关。
