PMID- 36399214
OWN - NLM
STAT- MEDLINE
DCOM- 20230517
LR  - 20230523
IS  - 1573-2614 (Electronic)
IS  - 1387-1307 (Print)
IS  - 1387-1307 (Linking)
VI  - 37
IP  - 3
DP  - 2023 Jun
TI  - Noninvasive intracranial pressure waveforms for estimation of intracranial 
      hypertension and outcome prediction in acute brain-injured patients.
PG  - 753-760
LID - 10.1007/s10877-022-00941-y [doi]
AB  - Analysis of intracranial pressure waveforms (ICPW) provides information on 
      intracranial compliance. We aimed to assess the correlation between noninvasive 
      ICPW (NICPW) and invasively measured intracranial pressure (ICP) and to assess 
      the NICPW prognostic value in this population. In this cohort, acute 
      brain-injured (ABI) patients were included within 5 days from admission in six 
      Intensive Care Units. Mean ICP (mICP) values and the P2/P1 ratio derived from 
      NICPW were analyzed and correlated with outcome, which was defined as: (a) early 
      death (ED); survivors on spontaneous breathing (SB) or survivors on mechanical 
      ventilation (MV) at 7 days from inclusion. Intracranial hypertension (IHT) was 
      defined by ICP > 20 mmHg. A total of 72 patients were included (mean age 39, 68% 
      TBI). mICP and P2/P1 values were significantly correlated (r = 0.49, p < 0.001). 
      P2/P1 ratio was significantly higher in patients with IHT and had an area under 
      the receiving operator curve (AUROC) to predict IHT of 0.88 (95% CI 0.78-0.98). 
      mICP and P2/P1 ratio was also significantly higher for ED group (n = 10) than the 
      other groups. The AUROC of P2/P1 to predict ED was 0.71 [95% CI 0.53-0.87], and 
      the threshold P2/P1 > 1.2 showed a sensitivity of 60% [95% CI 31-83%] and a 
      specificity of 69% [95% CI 57-79%]. Similar results were observed when 
      decompressive craniectomy patients were excluded. In this study, P2/P1 derived 
      from noninvasive ICPW assessment was well correlated with IHT. This information 
      seems to be as associated with ABI patients outcomes as ICP.Trial registration: 
      NCT03144219, Registered 01 May 2017 Retrospectively registered, 
      https://www.clinicaltrials.gov/ct2/show/NCT03144219 .
CI  - (c) 2022. The Author(s).
FAU - Brasil, Sergio
AU  - Brasil S
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil. 
      sbrasil@alumni.usp.br.
FAU - Frigieri, Gustavo
AU  - Frigieri G
AD  - Medical Investigation Laboratory 62, School of Medicine, University of Sao Paulo, 
      Sao Paulo, Brazil.
FAU - Taccone, Fabio Silvio
AU  - Taccone FS
AD  - Department of Intensive Care, Erasme Hopital, Universite Libre de Bruxelles, 
      Bruxelles, Belgium.
FAU - Robba, Chiara
AU  - Robba C
AD  - Department of Intensive Care, Universita degli Studi di Genoa, Genoa, Italy.
FAU - Solla, Davi Jorge Fontoura
AU  - Solla DJF
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil.
FAU - de Carvalho Nogueira, Ricardo
AU  - de Carvalho Nogueira R
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil.
FAU - Yoshikawa, Marcia Harumy
AU  - Yoshikawa MH
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil.
FAU - Teixeira, Manoel Jacobsen
AU  - Teixeira MJ
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil.
FAU - Malbouisson, Luiz Marcelo Sa
AU  - Malbouisson LMS
AD  - Department of Intensive Care, School of Medicine, University of Sao Paulo, Sao 
      Paulo, Brazil.
FAU - Paiva, Wellingson Silva
AU  - Paiva WS
AD  - Division of Neurosurgery, Department of Neurology, School of Medicine, University 
      of Sao Paulo, 255 Eneas Aguiar Street, Sao Paulo, 05403000, Brazil.
LA  - eng
SI  - ClinicalTrials.gov/NCT03144219
PT  - Clinical Trial
PT  - Journal Article
DEP - 20221118
PL  - Netherlands
TA  - J Clin Monit Comput
JT  - Journal of clinical monitoring and computing
JID - 9806357
SB  - IM
MH  - Adult
MH  - Humans
MH  - Brain
MH  - *Brain Injuries, Traumatic
MH  - *Intracranial Hypertension/diagnosis
MH  - Intracranial Pressure
MH  - Prognosis
PMC - PMC9673225
OTO - NOTNLM
OT  - Acute brain injury
OT  - Intracranial compliance
OT  - Intracranial hypertension
OT  - Intracranial pressure waveform
OT  - Neuromonitoring
COIS- SB has recently joined brain4care's scientific committee. GF is founder of 
      brain4care. The other authors declare no competing interest.
EDAT- 2022/11/19 06:00
MHDA- 2023/05/15 11:42
PMCR- 2022/11/18
CRDT- 2022/11/18 11:15
PHST- 2022/07/27 00:00 [received]
PHST- 2022/10/27 00:00 [accepted]
PHST- 2023/05/15 11:42 [medline]
PHST- 2022/11/19 06:00 [pubmed]
PHST- 2022/11/18 11:15 [entrez]
PHST- 2022/11/18 00:00 [pmc-release]
AID - 10.1007/s10877-022-00941-y [pii]
AID - 941 [pii]
AID - 10.1007/s10877-022-00941-y [doi]
PST - ppublish
SO  - J Clin Monit Comput. 2023 Jun;37(3):753-760. doi: 10.1007/s10877-022-00941-y. 
      Epub 2022 Nov 18.