TY - JOUR
T1 - The correlation between intracranial pressure and cerebral blood flow velocity during ICP plateau waves
AU - Lewis, Philip M.
AU - Smielewski, Peter
AU - Rosenfeld, Jeffrey V.
AU - Pickard, John D.
AU - Czosnyka, Marek
PY - 2016/5/1
Y1 - 2016/5/1
N2 - We previously showed that the flow-ICP index (Fix), a moving correlation coeffi cient between intracranial pressure (ICP) and cerebral blood flow velocity (CBFV), had marginally greater prognostic value for patients with traumatic brain injury (TBI) than an index of cerebral autoregulation (mean index, Mx). The aim of this study was to further examine the clinical and physiological relevance of Fix by studying its behaviour during ICP plateau waves in patients with TBI. Twenty-nine recordings of CBFV made during ICP plateau waves were analysed. Both Mx and Fix at baseline and peak ICP were signifi cantly different, although the magnitude of Fix change was slightly greater. The correlation between Fix and cerebral perfusion pressure (CPP) was stronger than that between Mx and CPP. Unlike in our previous study, plotting Fix against CPP revealed a peak value in the range of “optimal” CPP, as indicated by the Mxversus CPP plot. The fi ndings suggest that during periods of reduced CPP caused by plateau waves, the dynamicbehaviour of Fix is similar to that of a measure of cerebral autoregulation. This conclusion needs to be verified against similar results obtained during episodes of supranormal CPP.
AB - We previously showed that the flow-ICP index (Fix), a moving correlation coeffi cient between intracranial pressure (ICP) and cerebral blood flow velocity (CBFV), had marginally greater prognostic value for patients with traumatic brain injury (TBI) than an index of cerebral autoregulation (mean index, Mx). The aim of this study was to further examine the clinical and physiological relevance of Fix by studying its behaviour during ICP plateau waves in patients with TBI. Twenty-nine recordings of CBFV made during ICP plateau waves were analysed. Both Mx and Fix at baseline and peak ICP were signifi cantly different, although the magnitude of Fix change was slightly greater. The correlation between Fix and cerebral perfusion pressure (CPP) was stronger than that between Mx and CPP. Unlike in our previous study, plotting Fix against CPP revealed a peak value in the range of “optimal” CPP, as indicated by the Mxversus CPP plot. The fi ndings suggest that during periods of reduced CPP caused by plateau waves, the dynamicbehaviour of Fix is similar to that of a measure of cerebral autoregulation. This conclusion needs to be verified against similar results obtained during episodes of supranormal CPP.
KW - Cerebral autoregulation
KW - Cerebral blood flow velocity
KW - Intracranial pressure
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=84970998449&partnerID=8YFLogxK
U2 - 10.1007/978-3-319-22533-3_16
DO - 10.1007/978-3-319-22533-3_16
M3 - Article
AN - SCOPUS:84970998449
SN - 0065-1419
VL - 122
SP - 81
EP - 83
JO - Acta Neurochirurgica Supplement
JF - Acta Neurochirurgica Supplement
ER -