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创伤性脑损伤的结果、压力反应性与最佳脑灌注压计算:两种变体的比较

Outcome, Pressure Reactivity and Optimal Cerebral Perfusion Pressure Calculation in Traumatic Brain Injury: A Comparison of Two Variants.

作者信息

Lang Erhard W, Kasprowicz Magdalena, Smielewski Peter, Santos Edgar, Pickard John, Czosnyka Marek

机构信息

Neurosurgical, Red Cross Hospital, Bergmannstrasse 30, D-34121, Kassel, Germany.

Institute of Biomedical Engineering and Instrumentation, Wroclaw University of Technology, Wroclaw, Poland.

出版信息

Acta Neurochir Suppl. 2016;122:221-3. doi: 10.1007/978-3-319-22533-3_44.

Abstract

This study investigates the outcome prediction and calculation of optimal cerebral perfusion pressure (CPPopt) in 307 patients after severe traumatic brain injury (TBI) based on cerebrovascular reactivity calculation of a moving correlation correlation coefficient, named PRx, between mean arterial pressure (ABP) and intracranial pressure (ICP). The correlation coefficient was calculated from simultaneously recorded data using different frequencies. PRx was calculated from oscillations between 0.008 and 0.05Hz and the longPRx (L-PRx) was calculated from oscillations between 0.0008 and 0.016 Hz. PRx was a significant mortality predictor, whereas L-PRx was not. CPPopt for pooled data was higher for L-PRx than for PRx, with no statistical difference. Mortality was associated with mean CPP below CPPopt. Severe disability was associated with CPP above CPPopt (PRx). These relationships were not statistically significant for CPPopt (L-PRx). We conclude that PRx and L-PRx cannot be used interchangeably.

摘要

本研究基于平均动脉压(ABP)与颅内压(ICP)之间移动相关系数(称为PRx)的脑血管反应性计算,对307例重型颅脑损伤(TBI)患者的预后预测及最佳脑灌注压(CPPopt)的计算进行了调查。相关系数是根据使用不同频率同时记录的数据计算得出的。PRx是从0.008至0.05Hz的振荡中计算得出的,而长PRx(L-PRx)是从0.0008至0.016Hz的振荡中计算得出的。PRx是显著的死亡率预测指标,而L-PRx则不是。汇总数据的CPPopt中,L-PRx高于PRx,但无统计学差异。死亡率与平均CPP低于CPPopt相关。严重残疾与CPP高于CPPopt(PRx)相关。对于CPPopt(L-PRx),这些关系无统计学意义。我们得出结论,PRx和L-PRx不能互换使用。

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