Title Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades /
Authors Petkus, Vytautas ; Krakauskaitė, Solventa ; Preikšaitis, Aidanas ; Ročka, Saulius ; Chomskis, Romanas ; Ragauskas, Arminas
DOI 10.1016/j.medici.2016.01.004
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Is Part of Medicina.. Amsterdam : Elsevier. 2016, vol. 52, iss. 1, p. 46-53.. ISSN 1010-660X
Keywords [eng] outcome ; traumatic brain injury ; cerebrovascular autoregulation monitoring ; optimal cerebral perfusion pressure
Abstract [eng] Background and objective The aim of this study was to explore the association of cerebrovascular autoregulation (CA) and optimal cerebral perfusion pressure (CPP) managing conditions with the outcome of traumatic brain injury (TBI) patients including additional information about the patients’ age and grade of diffuse axonal injury (DAI). Materials and methods The CA monitoring of 28 TBI patients was performed by using ICM+ software (Cambridge, UK). The CA status estimating pressure reactivity indexes (PRx) and CPP data were processed in order to obtain information on the patient-specific treatment conditions by calculating the optimal CPP. Results There was a negative correlation between the Glasgow outcome scale (GOS) score and PRx (r = −0.448 at hospital discharge and r = −0.402 after 6 months). The estimated threshold value PRx of >0.24 was associated with mortality. The correlation coefficients between the GOS score and the difference CPP-optimal CPP were 0.549 at hospital discharge and 0.484 after 6 months. The threshold value of CPP declination from ΔCPPopt per −6 mmHg was associated with mortality. Poorer outcome was predicted for elderly TBI patients (aged >47 years) and patients having a DAI grade of 3. Conclusions The association of the GOS score with CPP, CA impairment conditions, age and diffuse axonal injury (DAI) grade showed that the outcomes of TBI patients were associated with patient-specific CPP management and better outcomes were obtained for younger patients, for patients having lower DAI grade and for patients whose CPP was kept within the range from the optimal CPP to the optimal CPP + 10 mmHg.
Published Amsterdam : Elsevier
Type Journal article
Language English
Publication date 2016