Trending autoregulatory indices during treatment for traumatic brain injury.
Our goal is to use automatic data monitoring for reliable prediction of episodes of intracranial hypertension in patients with traumatic brain injury. Here we test the validity of our method on retrospective patient data. We developed the Continuous Hemodynamic Autoregulatory Monitor (CHARM), that s...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 30; no. 6; pp. 821 - 832 |
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| Autores principales: | , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Dec2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120548719&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 120548719 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Dec2016 vid: 30 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 120548719 120548719 NLM26446002 10.1007/s10877-015-9779-3 NLM26446002 120548719 ppf: 821 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Trending autoregulatory indices during treatment for traumatic brain injury. aug: au: Kim, Nam Krasner, Alex Kosinski, Colin Wininger, Michael Qadri, Maria Kappus, Zachary Danish, Shabbar Craelius, William affil: Department of Biomedical Engineering , Rutgers, The State University of New Jersey , Piscataway 08854 USA sug: subj: Intracranial Hypertension Diagnosis Bar Coding Retrospective Design Computer Graphics Medical Informatics Hemodynamics Signal Processing, Computer Assisted Monitoring, Physiologic Methods Intracranial Pressure Linear Regression Cerebrovascular Circulation Artifacts Regression Automation Intensive Care Units ab: Our goal is to use automatic data monitoring for reliable prediction of episodes of intracranial hypertension in patients with traumatic brain injury. Here we test the validity of our method on retrospective patient data. We developed the Continuous Hemodynamic Autoregulatory Monitor (CHARM), that siphons and stores signals from existing monitors in the surgical intensive care unit (SICU), efficiently compresses them, and standardizes the search for statistical relationships between any proposed index and adverse events. CHARM uses an automated event detector to reliably locate episodes of elevated intracranial pressure (ICP), while eliminating artifacts within retrospective patient data. A graphical user interface allowed data scanning, selection of criteria for events, and calculating indices. The pressure reactivity index (PRx), defined as the least square linear regression slope of intracranial pressure versus arterial BP, was calculated for a single case that spanned 259 h. CHARM collected continuous records of ABP, ICP, ECG, SpO2, and ventilation from 29 patients with TBI over an 18-month period. Analysis of a single patient showed that PRx data distribution in the single hours immediately prior to all 16 intracranial hypertensive events, significantly differed from that in the 243 h that did not precede such events (p < 0.0001). The PRx index, however, lacked sufficient resolution as a real-time predictor of IH in this patient. CHARM streamlines the search for reliable predictors of intracranial hypertension. We report statistical evidence supporting the predictive potential of the pressure reactivity index. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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