Peter Smielewski1, Marcel J Aries2, Annalisa Liberti3,4, Erta Beqiri5,1, Ari Ercole6, Manuel Cabeleira1, Jeanette Tas2, Frederick A Zeiler6,7,8,9,10, Marek Czosnyka1. 1. Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK. 2. Department of Intensive Care, University Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands. 3. Department of Intensive Care, University Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands. liberti.annalisa@gmail.com. 4. Department of Physiology and Transplantation, Milan University, Milan, Italy. liberti.annalisa@gmail.com. 5. Department of Physiology and Transplantation, Milan University, Milan, Italy. 6. Division of Anesthesia, University of Cambridge, Cambridge, UK. 7. Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 8. Department of Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada. 9. Biomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, Canada. 10. Centre on Aging, University of Manitoba, Winnipeg, Canada.
Abstract
BACKGROUND: The 'optimal' CPP (CPPopt) concept is based on the vascular pressure reactivity index (PRx). The feasibility and effectiveness of CPPopt guided therapy in severe traumatic brain injury (TBI) patients is currently being investigated prospectively in the COGiTATE trial. At the moment there is no clear evidence that certain admission and treatment characteristics are associated with CPPopt availability (yield). OBJECTIVE: To test the relation between patients' admission and treatment characteristics and the average CPPopt yield. METHODS: Retrospective analysis of 230 patients from the CENTER-TBI high-resolution database with intracranial pressure (ICP) measured using an intraparenchymal probe. CPPopt was calculated using the algorithm set for the COGiTATE study. CPPopt yield was defined as the percentage of CPP monitored time (%) when CPPopt is available. The variables in the statistical model included age, admission Glasgow Coma Scale (GCS), gender, pupil response, hypoxia and hypotension at the scene, Marshall computed tomography (CT) score, decompressive craniectomy, injury severity score score and 24-h therapeutic intensity level (TIL) score. RESULTS: The median CPPopt yield was 80.7% (interquartile range 70.9-87.4%). None of the selected variables showed a significant statistical correlation with the CPPopt yield. CONCLUSION: In this retrospective multicenter study, none of the selected admission and treatment variables were related to the CPPopt yield.
BACKGROUND: The 'optimal' CPP (CPPopt) concept is based on the vascular pressure reactivity index (PRx). The feasibility and effectiveness of CPPopt guided therapy in severe traumatic brain injury (TBI) patients is currently being investigated prospectively in the COGiTATE trial. At the moment there is no clear evidence that certain admission and treatment characteristics are associated with CPPopt availability (yield). OBJECTIVE: To test the relation between patients' admission and treatment characteristics and the average CPPopt yield. METHODS: Retrospective analysis of 230 patients from the CENTER-TBI high-resolution database with intracranial pressure (ICP) measured using an intraparenchymal probe. CPPopt was calculated using the algorithm set for the COGiTATE study. CPPopt yield was defined as the percentage of CPP monitored time (%) when CPPopt is available. The variables in the statistical model included age, admission Glasgow Coma Scale (GCS), gender, pupil response, hypoxia and hypotension at the scene, Marshall computed tomography (CT) score, decompressive craniectomy, injury severity score score and 24-h therapeutic intensity level (TIL) score. RESULTS: The median CPPopt yield was 80.7% (interquartile range 70.9-87.4%). None of the selected variables showed a significant statistical correlation with the CPPopt yield. CONCLUSION: In this retrospective multicenter study, none of the selected admission and treatment variables were related to the CPPopt yield.
Authors: Andrea Lavinio; Bogdan Ene-Iordache; Ilaria Nodari; Alan Girardini; Elena Cagnazzi; Frank Rasulo; Piotr Smielewski; Marek Czosnyka; Nicola Latronico Journal: Acta Neurochir Suppl Date: 2008
Authors: Erta Beqiri; Peter Smielewski; Chiara Robba; Marek Czosnyka; Manuel Teixeira Cabeleira; Jeanette Tas; Joseph Donnelly; Joanne G Outtrim; Peter Hutchinson; David Menon; Geert Meyfroidt; Bart Depreitere; Marcel J Aries; Ari Ercole Journal: BMJ Open Date: 2019-09-20 Impact factor: 2.692