Lack of consistent intracranial pressure pulse morphological changes during episodes of microdialysis lactate/pyruvate ratio increase.
Lack of consistent intracranial pressure pulse morphological changes during episodes of microdialysis lactate/pyruvate ratio increase.
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DOI：
10.1088/0967-3334/32/10/011
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发表时间：
2011-10
影响因子：
3.2
通讯作者：
Hu X
中科院分区：
文献类型：
--
作者：
Asgari S;Vespa P;Bergsneider M;Hu X
来自微透析的乳酸/丙酮酸比（LPR）是脑代谢危象的公认标志物。对于脑损伤患者，异常高的LPR可能表明脑缺血或O2摄取失败。然而，对于LPR上升的主要因素是什么，存在争议。利用高时间分辨率信号（如颅内脉冲（ICP））的形态学来表征脑血管变化的潜力，进行数据分析实验，以测试是否一致的变化ICP脉冲形态指标伴随LPR的增加。我们研究了19例严重创伤性脑损伤（TBI）患者3517小时的LPR和连续ICP数据。我们的形态聚类和颅内压分析（MOCAIP）算法应用于ICP脉冲，这是匹配的时间LPR测量，并提取128脉冲形态指标。我们使用10至20小时的移动时间窗自动识别LPR上升的事件。然后，我们研究了这些确定时期内128个ICP MOCAIP指标中每一个指标的趋势模式，并将其确定为以下三种类型之一：增加，减少或无趋势。采用二项式检验来研究任何MOCAIP指标是否在每例患者的所有LPR增加事件中显示出一致的趋势类型。无论所提出的方法的不同参数的选定值如何，对于研究中的大多数受试者（78%），在LPR升高期间，没有任何ICP指标显示出任何一致的趋势。即使对于在LPR升高发作期间至少有一个ICP指标具有一致趋势的少数受试者，此类指标的数量也很少，并且因受试者而异。鉴于ICP脉冲形态受脑血管影响的事实，我们的研究结果表明，一个占主导地位的脑血管原因可能是LPR的变化背后的LPR的趋势与ICP脉冲形态变化相关时。然而，这种相关性的发生率似乎很低。
Lactate/Pyruvate ratio (LPR) from microdialysis is a well established marker of cerebral metabolic crisis. For brain injury patients, abnormally high LPR could indicate cerebral ischemia or failure of O2 uptake. However, there is a debate on what is primary factor responsible for LPR increase. Exploiting the potential of using the morphology of a high temporal resolution signal such as intracranial pulse (ICP) to characterize cerebrovascular changes, a data analysis experiment is taken to test whether consistent changes in ICP pulse morphological metrics accompany the LPR increase. We studied 3517 hours of LPR and continuous ICP data from 19 severe traumatic brain injury (TBI) patients. Our Morphological Clustering and Analysis of Intracranial Pressure (MOCAIP) algorithm was applied to ICP pulses, which were matched in time to the LPR measurements, and 128 pulse morphological metrics were extracted. We automatically identified the episodes of LPR increases using a moving time-window of 10 to 20 hours. We then studied the trending patterns of each of the 128 ICP MOCAIP metrics within these identified periods and determined them to be one of the following three types: increasing, decreasing, or no-trend. A binomial test was employed to investigate whether any MOCAIP metrics shows a consistent type of trend among all episodes of LPR increase per patient. Regardless of the selected values for different parameters of the proposed method, for the majority of the subjects in the study (78%), none of the ICP metrics show any consistent trend during the episodes of LPR increase. Even for the few subjects who have at least one ICP metric with a consistent trend during the LPR increase episodes, the number of such metrics is small and varies from subject to subject. Given the fact that ICP pulse morphology is influenced by the cerebral vasculature, our results suggest that a dominant cerebral vascular cause may be behind the changes in LPR when LPR trends correlate with ICP pulse morphological changes. However, incidence of such correlation seems to be low.
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DOI：
10.1109/tbme.2008.2008636
发表时间：
2009-03
期刊：
IEEE transactions on bio-medical engineering
影响因子：
--
作者：
Hu X;Xu P;Scalzo F;Vespa P;Bergsneider M
通讯作者：
Bergsneider M
影响因子：
3.2
作者：
Scalzo, Fabien;Xu, Peng;Asgari, Shadnaz;Bergsneider, Marvin;Hu, Xiao
通讯作者：
Hu, Xiao
影响因子：
3.5
作者：
Asgari, Shadnaz;Bergsneider, Marvin;Hamilton, Robert;Vespa, Paul;Hu, Xiao
通讯作者：
Hu, Xiao
影响因子：
3.7
作者：
HADI, AS;SIMONOFF, JS
通讯作者：
SIMONOFF, JS
DOI：
10.1080/03610927708827533
发表时间：
1977-01-01
期刊：
COMMUNICATIONS IN STATISTICS PART A-THEORY AND METHODS
影响因子：
--
作者：
HOLLAND, PW;WELSCH, RE
通讯作者：
WELSCH, RE