Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, Canada.
Undergraduate Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, Canada.
Physiol Meas. 2024 Jun 26;45(6). doi: 10.1088/1361-6579/ad4f4a.
Continuous monitoring of cerebrospinal compliance (CC)cerebrospinal compensatory reserve (CCR) is crucial for timely interventions and preventing more substantial deterioration in the context of acute neural injury, as it enables the early detection of abnormalities in intracranial pressure (ICP). However, to date, the literature on continuous CC/CCR monitoring is scattered and occasionally challenging to consolidate.We subsequently conducted a systematic scoping review of the human literature to highlight the available continuous CC/CCR monitoring methods.This systematic review incorporated a total number of 76 studies, covering diverse patient types and focusing on three primary continuous CC or CCR monitoring metrics and methods-Moving Pearson's correlation between ICP pulse amplitude waveform and ICP, referred to as RAP, the Spiegelberg Compliance Monitor, changes in cerebral blood flow velocity with respect to the alternation of ICP measured through transcranial doppler (TCD), changes in centroid metric, high frequency centroid (HFC) or higher harmonics centroid (HHC), and the P2/P1 ratio which are the distinct peaks of ICP pulse wave. The majority of the studies in this review encompassed RAP metric analysis (= 43), followed by Spiegelberg Compliance Monitor (= 11), TCD studies (= 9), studies on the HFC/HHC (= 5), and studies on the P2/P1 ratio studies (= 6). These studies predominantly involved acute traumatic neural injury (i.e. Traumatic Brain Injury) patients and those with hydrocephalus. RAP is the most extensively studied of the five focused methods and exhibits diverse applications. However, most papers lack clarification on its clinical applicability, a circumstance that is similarly observed for the other methods.Future directions involve exploring RAP patterns and identifying characteristics and artifacts, investigating neuroimaging correlations with continuous CC/CCR and integrating machine learning, holding promise for simplifying CC/CCR determination. These approaches should aim to enhance the precision and accuracy of the metric, making it applicable in clinical practice.
持续监测脑顺应性（CC）和脑代偿储备（CCR）对于急性神经损伤情况下的及时干预和防止更严重的恶化至关重要，因为它能够早期发现颅内压（ICP）的异常。然而，迄今为止，关于连续 CC/CCR 监测的文献分散且有时难以整合。
因此，我们对人类文献进行了系统的范围综述，以突出可用的连续 CC/CCR 监测方法。
该系统综述共纳入了 76 项研究，涵盖了不同类型的患者，并侧重于三种主要的连续 CC 或 CCR 监测指标和方法——ICP 脉冲幅度波形与 ICP 之间的移动 Pearson 相关（RAP）、Spiegelberg 顺应性监测仪、经颅多普勒（TCD）测量的 ICP 交替时脑血流速度的变化、质心指标的变化、高频质心（HFC）或更高谐波质心（HHC）以及 ICP 脉冲波的独特峰值 P2/P1 比。
本综述中的大多数研究都涉及 RAP 指标分析（=43），其次是 Spiegelberg 顺应性监测仪（=11）、TCD 研究（=9）、HFC/HHC 研究（=5）和 P2/P1 比研究（=6）。这些研究主要涉及急性创伤性神经损伤（即创伤性脑损伤）患者和脑积水患者。RAP 是这五种重点方法中研究最广泛的方法，具有多种应用。然而，大多数论文都没有澄清其临床适用性，其他方法也存在类似情况。
未来的方向包括探索 RAP 模式，识别特征和伪影，研究与连续 CC/CCR 的神经影像学相关性以及整合机器学习，有望简化 CC/CCR 的确定。这些方法应旨在提高指标的精度和准确性，使其在临床实践中具有适用性。
