Chapter title |
Increasing Intracranial Pressure After Head Injury: Impact on Respiratory Oscillations in Cerebral Blood Flow Velocity.
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Chapter number | 35 |
Book title |
Intracranial Pressure and Brain Monitoring XV
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Published in |
Acta neurochirurgica Supplement, January 2016
|
DOI | 10.1007/978-3-319-22533-3_35 |
Pubmed ID | |
Book ISBNs |
978-3-31-922532-6, 978-3-31-922533-3
|
Authors |
Haubrich, Christina, Diehl, Rolf R, Kasprowicz, Magdalena, Diedler, Jennifer, Sorrentino, Enrico, Smielewski, Piotr, Czosnyka, Marek, Christina Haubrich MD, Rolf R. Diehl MD, Magdalena Kasprowicz, Jennifer Diedler PhD, Enrico Sorrentino MD, Piotr Smielewski PhD, Marek Czosnyka PhD, Diehl, Rolf R., Christina Haubrich, Rolf R. Diehl, Jennifer Diedler, Enrico Sorrentino, Piotr Smielewski, Marek Czosnyka |
Editors |
Beng-Ti Ang |
Abstract |
Experiments have shown that closed-box conditions alter the transmission of respiratory oscillations (R waves) to organ blood flow already at a marginal pressure increase. How does the increasing intracranial pressure (ICP) interact with R waves in cerebral blood flow after head injury (HI)?Twenty-two head-injured patients requiring sedation and mechanical ventilation were monitored for ICP, Doppler flow velocity (FV) in the middle cerebral arteries, and arterial blood pressure (ABP). The analysis included transfer function gains of R waves (9-20 cpm) from ABP to FV, and indices of pressure-volume reserve (RAP) and autoregulation (Mx). Increasing ICP has dampened R-wave gains from day 1 to day 4 after HI in all patients. A large impact (ΔGain /ΔICP right: 0.14 ± 0.06; left: 0.18 ± 0.08) was associated with exhausted reserves (RAP ≥0.85). When RAP was <0.85, rising ICP had a lower impact on R-wave gains (ΔGain /ΔICP right: 0.05 ± 0.02; left: 0.06 ± 0.04; p < 0.05), but increased the pulsatility indices (right: 1.35 ± 0.55; left: 1.25 ± 0.52) and Mx indices (right: 0.30 ± 0.12; left: 0.28 ± 0.08, p < 0.05). Monitoring of R waves in blood pressure and cerebral blood flow velocity has suggested that rising ICP after HI might have an impact on cerebral blood flow directly, even before autoregulation is impaired. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 28 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Ph. D. Student | 5 | 18% |
Student > Bachelor | 5 | 18% |
Student > Master | 3 | 11% |
Researcher | 2 | 7% |
Student > Postgraduate | 2 | 7% |
Other | 4 | 14% |
Unknown | 7 | 25% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 12 | 43% |
Computer Science | 3 | 11% |
Nursing and Health Professions | 2 | 7% |
Philosophy | 1 | 4% |
Psychology | 1 | 4% |
Other | 3 | 11% |
Unknown | 6 | 21% |