Slow vasogenic fluctuations of intracranial pressure and cerebral near infrared spectroscopy-an observational study
Slow vasogenic fluctuations of intracranial pressure and cerebral near infrared spectroscopy-an observational study
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DOI：
10.1007/s00701-010-0748-9
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发表时间：
2010-10-01
影响因子：
2.4
通讯作者：
Czosnyka, Zofia
中科院分区：
文献类型：
--
作者：
Weerakkody, Ruwan A.;Czosnyka, Marek;Czosnyka, Zofia
颅内压慢波活动增加意味着脑脊液代偿储备在一系列情况下耗尽。在这项研究中，我们试图描述在颅内压控制升高期间，颅内压慢波和近红外光谱(NIRS)变量之间的同步性。19名出现症状性脑积水的患者接受了计算机输液测试。同时记录NIRS衍生指数、颅内压和动脉血压，在输液过程中，颅内压从9.3(6.0)mm Hg上升到17.1(8.9)mm Hg。颅内压慢波伴随各NIRS变量(包括脱氧血红蛋白(Hb)和氧合血红蛋白(HBO2))的并行波，平均相干性为>；0.7，无明显相移。在相同的带宽下(0.3-1.8min(-1))，ABP相对于颅内压的相干性为0.77，相位超前40A度。在输液平台期，颅内压慢波的功率明显增加，而Hb波的功率也相应增加。近红外光谱检测到的脑氧饱和度缓慢波动与颅内压慢波的起源相吻合，并与脑脊液代偿储备耗竭时的增加有关。NIRS可作为颅内压慢波增加(从而降低脑脊液代偿储备)的无创性指标。
Increased slow-wave activity in intracranial pressure (ICP) signifies an exhausted cerebrospinal compensatory reserve across a range of conditions. In this study, we attempted to describe synchronisation between slow waves of ICP and of near-infrared spectroscopy (NIRS) variables during controlled elevation of ICP.Nineteen patients presenting with symptomatic hydrocephalus underwent a Computerised Infusion Test. NIRS-derived indices, ICP and arterial blood pressure (ABP) were recorded simultaneously.ICP increased from 9.3 (6.0) mmHg to a 17.1 (8.9) mmHg during infusion. Slow waves in ICP were accompanied by concurrent waves in each NIRS variable (including deoxygenated haemoglobin (Hb) and oxygenated haemoglobin (HbO2)) with a mean coherence of > 0.7 and no significant phase shift. In the same bandwidth (0.3-1.8 min(-1)), ABP fluctuations occurred with a coherence of 0.77 and phase lead of 40A degrees with respect to ICP. The power of ICP slow waves increased significantly during infusion plateau with a corresponding increase in power of Hb waves.Slow fluctuations in cerebral oximetry as detected by NIRS coincide with and are implicated in the origin of ICP slow waves and increases during periods of exhausted cerebrospinal compensatory reserve. NIRS may be used as a non-invasive marker of increased ICP slow waves (and therefore reduced CSF compensatory reserve).