Faculty of Engineering, University of Porto, Porto, Portugal.
Department of Intensive Care, Centro Hospitalar Universitário São João, Porto, Portugal.
Acta Neurochir Suppl. 2021;131:249-253. doi: 10.1007/978-3-030-59436-7_47.
Plateau waves are recurrent phenomena observed in traumatic brain injury (TBI) patients, characterised by an increase in intracranial pressure (ICP) above 40 mmHg combined with an almost zero arterial blood pressure (ABP) variation and, hence, a decrease in cerebral perfusion pressure (CPP). A raised ICP for a long period of time, namely plateau waves, can lead to a secondary brain injury. Due to the impaired cerebral autoregulation mechanism these TBI patients present, they are admitted to neurocritical care units (NCCUs) to be under continuous multimodal monitoring, which allows a correct diagnosis for each patient. Plateau waves can end naturally by activating a vasoconstriction mechanism which decreases the amount of blood available in the brain. Alternatively, the phenomenon can end with therapeutic treatment.In this sense, the present study consists in the development of an algorithm capable of automatically detecting plateau waves using offline data, i.e. data already collected from patients. This creates an extra tool which allows for faster detection of events to assist their identification and final diagnosis. Despite the additional steps that can be included to improve the algorithm, the results show good performance, and thus it may be applied in NCCUs.
高原波是颅脑创伤（TBI）患者中反复出现的现象，其特征是颅内压（ICP）升高至 40mmHg 以上，同时动脉血压（ABP）几乎没有变化，因此脑灌注压（CPP）降低。长时间的高 ICP，即高原波，可能导致继发性脑损伤。由于这些 TBI 患者的脑自动调节机制受损，他们被收入神经重症监护病房（NCCU）进行持续的多模态监测，以便对每位患者做出正确的诊断。高原波可以通过激活血管收缩机制自然结束，该机制会减少大脑中的血液供应。或者，该现象可以通过治疗来结束。在这种情况下，本研究旨在开发一种能够使用离线数据（即已经从患者身上收集的数据）自动检测高原波的算法。这为更快地检测事件提供了一个额外的工具，以协助识别和最终诊断。尽管可以包括额外的步骤来改进算法，但结果表明其性能良好，因此可以在 NCCU 中应用。
