OBJECTIVE: To summarize our experience from the first 2 years of use of the ICM+ software in our Neurocritical Care Unit (NCCU). MATERIALS AND METHODS: Ninety-five head-injured patients (74 males, 21 females), average age 36 years, were managed in the NCCU. Intracranial pressure (ICP) was monitored using Codman intraparenchymal probes and arterial blood pressure (ABP) was measured from the radial artery. Signals were monitored by ICM+ software calculating mean values of ICP, ABP, cerebral perfusion pressure (CPP) and various indices describing pressure reactivity, compensation and vascular waveforms of ICP (pulse amplitude, respiratory, and slow waves), etc. RESULTS: Mean ICP was 17 mmHg, mean CPP was 73 mmHg. Seven patients showed permanent disturbance of cerebral autoregulation (mean pressure reactivity index above 0.3). Pressure reactivity index demonstrated significant U-shape relationship with CPP, suggesting loss of pressure reactivity at too low (CPP < 55 mmHg) and too high CPPs (CPP > 95 mmHg). Mean ICP was inversely correlated with respiratory rate (R = 0.46; p < 0.0001; reciprocal model). CONCLUSION: The new version of ICM+ software proved to be useful clinically in the NCCU. It allows continuous monitoring of pressure reactivity and exploratory analysis of factors implicating intracranial hypertension.
OBJECTIVE: To summarize our experience from the first 2 years of use of the ICM+ software in our Neurocritical Care Unit (NCCU). MATERIALS AND METHODS: Ninety-five head-injured patients (74 males, 21 females), average age 36 years, were managed in the NCCU. Intracranial pressure (ICP) was monitored using Codman intraparenchymal probes and arterial blood pressure (ABP) was measured from the radial artery. Signals were monitored by ICM+ software calculating mean values of ICP, ABP, cerebral perfusion pressure (CPP) and various indices describing pressure reactivity, compensation and vascular waveforms of ICP (pulse amplitude, respiratory, and slow waves), etc. RESULTS: Mean ICP was 17 mmHg, mean CPP was 73 mmHg. Seven patients showed permanent disturbance of cerebral autoregulation (mean pressure reactivity index above 0.3). Pressure reactivity index demonstrated significant U-shape relationship with CPP, suggesting loss of pressure reactivity at too low (CPP < 55 mmHg) and too high CPPs (CPP > 95 mmHg). Mean ICP was inversely correlated with respiratory rate (R = 0.46; p < 0.0001; reciprocal model). CONCLUSION: The new version of ICM+ software proved to be useful clinically in the NCCU. It allows continuous monitoring of pressure reactivity and exploratory analysis of factors implicating intracranial hypertension.
Authors: Enrico Sorrentino; Karol P Budohoski; Magdalena Kasprowicz; Peter Smielewski; Basil Matta; John D Pickard; Marek Czosnyka Journal: Neurocrit Care Date: 2011-04 Impact factor: 3.210
Authors: Gianluca Castellani; Christian Zweifel; Dong-Joo Kim; Emmanuel Carrera; Danila K Radolovich; Piotr Smielewski; Peter J Hutchinson; John D Pickard; Marek Czosnyka Journal: Neurocrit Care Date: 2009-06-30 Impact factor: 3.210
Authors: C A C Wijman; S M Smirnakis; P Vespa; K Szigeti; W C Ziai; M M Ning; J Rosand; D F Hanley; R Geocadin; C Hall; P D Le Roux; J I Suarez; O O Zaidat Journal: Neurocrit Care Date: 2012-02 Impact factor: 3.210
Authors: Ken M Brady; Jennifer K Lee; Kathleen K Kibler; R Blaine Easley; Raymond C Koehler; Donald H Shaffner Journal: Stroke Date: 2008-07-31 Impact factor: 7.914
Authors: Nam Kim; Alex Krasner; Colin Kosinski; Michael Wininger; Maria Qadri; Zachary Kappus; Shabbar Danish; William Craelius Journal: J Clin Monit Comput Date: 2015-10-07 Impact factor: 2.502