Chapter title |
Plateau Waves of Intracranial Pressure and Partial Pressure of Cerebral Oxygen.
|
---|---|
Chapter number | 36 |
Book title |
Intracranial Pressure and Brain Monitoring XV
|
Published in |
Acta neurochirurgica Supplement, January 2016
|
DOI | 10.1007/978-3-319-22533-3_36 |
Pubmed ID | |
Book ISBNs |
978-3-31-922532-6, 978-3-31-922533-3
|
Authors |
Lang, Erhard W, Kasprowicz, Magdalena, Smielewski, Peter, Pickard, John, Czosnyka, Marek, Erhard W. Lang MD PhD, Magdalena Kasprowicz PhD, Peter Smielewski PhD, John Pickard MChir, FMedSci, Marek Czosnyka PhD, Lang, Erhard W., Erhard W. Lang, Magdalena Kasprowicz, Peter Smielewski, John Pickard, Marek Czosnyka |
Editors |
Beng-Ti Ang |
Abstract |
This study investigates 55 intracranial pressure (ICP) plateau waves recorded in 20 patients after severe traumatic brain injury (TBI) with a focus on a moving correlation coefficient between mean arterial pressure (ABP) and ICP, called PRx, which serves as a marker of cerebrovascular reactivity, and a moving correlation coefficient between ABP and cerebral partial pressure of oxygen (pbtO2), called ORx, which serves as a marker for cerebral oxygen reactivity. ICP and ICPamplitude increased significantly during the plateau waves, whereas CPP and pbtO2 decreased significantly. ABP, ABP amplitude, and heart rate remained unchanged. In 73 % of plateau waves PRx increased during the wave. ORx showed an increase during and a decrease after the plateau waves, which was not statistically significant. Our data show profound cerebral vasoparalysis on top of the wave and, to a lesser extent, impairment of cerebral oxygen reactivity. The different behavior of the indices may be due to the different latencies of the cerebral blood flow and oxygen level control mechanisms. While cerebrovascular reactivity is a rapidly reacting mechanism, cerebral oxygen reactivity is slower. |
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