Reduced complexity of intracranial pressure observed in short time series of intracranial hypertension following traumatic brain injury in adults.

Physiological parameters, such as intracranial pressure (ICP), are regulated by interconnected feedback loops, resulting in a complex time course. According to the decomplexification theory, disease is characterised by a loss of feedback loops resulting in a reduced complexity of the time course of...

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Publicado en:Journal of Clinical Monitoring & Computing Vol. 27; no. 4; pp. 395 - 404
Autores principales: Soehle, Martin, Gies, Bernadette, Smielewski, Peter, Czosnyka, Marek
Formato: research Journal Article
Publicado: Springer Nature Aug2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2013
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      pub: Springer Nature
      place: New York, New York
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        atl: Reduced complexity of intracranial pressure observed in short time series of intracranial hypertension following traumatic brain injury in adults.
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          Soehle, Martin
          Gies, Bernadette
          Smielewski, Peter
          Czosnyka, Marek
        affil: Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany, martin.soehle@ukb.uni-bonn.de.
      sug:
        subj:
          Blood Pressure Determination Equipment and Supplies
          Blood Pressure Determination Methods
          Brain Injuries Physiopathology
          Intracranial Hypertension Physiopathology
          Intracranial Pressure
          Monitoring, Physiologic Equipment and Supplies
          Adult
          Brain Injuries Complications
          Female
          Human
          Intracranial Hypertension Complications
          Male
          Middle Age
          Monitoring, Physiologic Methods
          Retrospective Design
          Software
          Time Factors
          Young Adult
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Physiological parameters, such as intracranial pressure (ICP), are regulated by interconnected feedback loops, resulting in a complex time course. According to the decomplexification theory, disease is characterised by a loss of feedback loops resulting in a reduced complexity of the time course of physiological parameters. We hypothesized that complexity of the ICP time series is decreased during periods of intracranial hypertension (IHT) following adult traumatic brain injury. In an observational retrospective cohort study, ICP was continuously monitored using intraparenchymally implanted probes and stored using ICM + -software. Periods of IHT (ICP > 25 mmHg for at least 1,024 s), were compared with preceding periods of intracranial normotension (ICP < 20 mmHg) and analysed at 1 s-intervals. ICP data (length = 1,024 s) were normalised (mean = 0, SD = 1) and complexity was estimated using the scaling exponent α (as derived from detrended fluctuation analysis), sample entropy (SampEn, m = 1, r = 0.2 × SD) and multiscale entropy. 344 episodes were analysed in 22 patients. During IHT (ICP = 31.7 ± 7.8 mmHg, mean ± SD), α was significantly elevated (α = 1.02 ± 0.22, p < 0.001) and SampEn significantly reduced (SampEn = 1.45 ± 0.46, p = 0.004) as compared to before IHT (ICP = 15.7 ± 3.2 mmHg, α = 0.81 ± 0.14, SampEn = 1.81 ± 0.24). In addition, MSE revealed a significantly (p < 0.05) decreased entropy at scaling factors ranging from 1 to 10. Both the increase in α as well as the decrease in SampEn and MSE indicate a loss of ICP complexity. Therefore following traumatic brain injury, periods of IHT seem to be characterised by a decreased complexity of the ICP waveform.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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