Metzger Anja, Mulligan Jane, Grudic Greg
Department of Emergency Medicine, University of Minnesota, 717 Delaware Street SE, Suite 508, Minneapolis, MN 55455.
Zoll Minneapolis, 1905 Cty Rd C West, Roseville, MN 55113.
Mil Med. 2018 Mar 1;183(suppl_1):119-123. doi: 10.1093/milmed/usx198.
New tools for diagnosis, monitoring, and treatment of elevated intracranial pressure (ICP) or compromised cerebral perfusion pressure (CPP) are urgently needed to improve outcomes after brain injury. Previous success in applying advanced data analytics to build precision monitors based on large, noisy sensor datasets suggested applying the same approach to monitor cerebrovascular status. In these experiments, a new algorithm was developed to estimate ICP and CPP using the arterial pressure waveform.
Sixty-five porcine subjects were subjected to a focal brain injury to simulate a mass lesion with elevated ICP. The arterial pressure waveform and the measured ICP from these subjects during injury and treatment were then utilized to develop and calibrate an ICP and CPP estimation algorithm. These estimation algorithms were then subsequently evaluated on 14 new subjects.
The root mean square difference between actual ICP and estimated ICP was 2.0961 mmHg. The root mean square difference between the actual CPP and the estimated CPP was 2.6828 mmHg.
A novel ICP or CPP monitor based on the arterial pressure signal produced a very close approximation to actual measured ICP and CPP and warrants further evaluation.
迫切需要用于诊断、监测和治疗颅内压（ICP）升高或脑灌注压（CPP）受损的新工具，以改善脑损伤后的预后。此前在应用先进数据分析基于大量嘈杂的传感器数据集构建精确监测器方面取得的成功表明，可采用相同方法监测脑血管状态。在这些实验中，开发了一种新算法，利用动脉压波形估计ICP和CPP。
对65只猪进行局灶性脑损伤，以模拟伴有ICP升高的占位性病变。然后利用这些动物在损伤和治疗期间的动脉压波形及测量的ICP来开发和校准ICP及CPP估计算法。随后在14只新动物身上对这些估计算法进行评估。
实际ICP与估计ICP之间的均方根差为2.0961 mmHg。实际CPP与估计CPP之间的均方根差为2.6828 mmHg。
基于动脉压信号的新型ICP或CPP监测器与实际测量的ICP和CPP非常接近，值得进一步评估。
