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创伤性脑损伤患者的颅内顺应性和容量测定

Intracranial compliance and volumetry in patients with traumatic brain injury.

作者信息

Link Caroline, D Haese Thomas Markus, Frigieri Gustavo, Brasil Sérgio, Vellosa José Carlos Rebuglio, Welling Leonardo

机构信息

Department of Neurology, Clinics Hospital Complex of the Federal University of Paraná, Curitiba, Brazil.

Department of Intensive care, State University of Ponta Grossa, Ponta Grossa, Brazil.

出版信息

Surg Neurol Int. 2023 Jul 14;14:246. doi: 10.25259/SNI_314_2023. eCollection 2023.

Abstract

BACKGROUND

Cerebral edema (CE) and intracranial hypertension (IHT) are complications of numerous neurological pathologies. However, the study of CE and noninvasive methods to predict IHT remains rudimentary. This study aims to identify in traumatic brain injury (TBI) patients the relationship between the volume of the lateral ventricles and the parameters of the noninvasive intracranial pressure waveform (nICPW).

METHODS

This is an analytical, descriptive, and cross-sectional study with nonsurgical TBI patients. The monitoring of nICPW was performed with a mechanical strain gauge, and the volumetry of the lateral ventricles was calculated using the free 3D Slicer software, both during the acute phase of the injury. The linear model of fixed and random mixed effects with Gamma was used to calculate the influence of nICPW parameters (P2/P1 and time-to-peak [TTP]) values on volumetry.

RESULTS

Considering only the fixed effects of the sample, there was = 0.727 (95% CI [-0.653; 0.364]) for the relationship between P2/P1 and volumetry and 0.727 (95% CI [-1.657; 1.305]) for TTP and volumetry. Considering the fixed and random effects, there was = 8.5e-10 (95% CI [-0.759; 0.355]) for the relationship between P2/P1 and volumetry and 8.5e-10 (95% CI [-2.001; 0.274]) for TTP and volumetry.

CONCLUSION

The present study with TBI patients found association between nICPW parameters and the volume of the lateral ventricles in the 1 days after injury.

摘要

背景

脑水肿(CE)和颅内高压(IHT)是众多神经病理学的并发症。然而,关于CE及预测IHT的非侵入性方法的研究仍处于初级阶段。本研究旨在确定创伤性脑损伤(TBI)患者侧脑室体积与非侵入性颅内压波形(nICPW)参数之间的关系。

方法

这是一项针对非手术TBI患者的分析性、描述性横断面研究。在损伤急性期,使用机械应变仪监测nICPW,并使用免费的3D Slicer软件计算侧脑室容积。采用固定和随机混合效应的伽马线性模型计算nICPW参数(P2/P1和峰值时间[TTP])值对容积的影响。

结果

仅考虑样本的固定效应时,P2/P1与容积之间的关系为 = 0.727(95%CI[-0.653;0.364]),TTP与容积之间的关系为0.727(95%CI[-1.657;1.305])。考虑固定和随机效应时,P2/P1与容积之间的关系为 = 8.5e-10(95%CI[-0.759;0.355]),TTP与容积之间的关系为8.5e-10(95%CI[-2.001;0.274])。

结论

本研究对TBI患者的研究发现,损伤后1天内nICPW参数与侧脑室体积之间存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08c/10408625/70ed199386bf/SNI-14-246-g001.jpg

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