Consistent changes in intracranial pressure waveform morphology induced by acute hypercapnic cerebral vasodilatation.
Consistent changes in intracranial pressure waveform morphology induced by acute hypercapnic cerebral vasodilatation.
复制标题
DOI：
10.1007/s12028-010-9463-x
复制
发表时间：
2011-08
影响因子：
3.5
通讯作者：
Hu, Xiao
中科院分区：
文献类型：
--
作者：
Asgari, Shadnaz;Bergsneider, Marvin;Hamilton, Robert;Vespa, Paul;Hu, Xiao
颅内压（ICP）仍然是神经危重症监护病房治疗脑损伤和蛛网膜下腔出血（SAH）患者的关键生理信号。考虑到颅内压的血管起源，颅内压波形形态的变化可以用来推断脑血管的变化。由于脑血管系统状态的多因素影响和不确定性，在脑外伤和SAH的情况下，这种关联的临床验证具有挑战性。为了获得一个更可控的环境，在这篇文章中，我们研究了四名未受伤的患者在二氧化碳吸入挑战中记录的ICP信号，高碳酸血症引起急性脑血管舒张。我们应用形态学聚类和颅内压分析（MOCAIP）算法识别了单个ICP脉冲的六个标志（基于三个已建立的ICP子峰；P1， P2和P3），并提取了128个ICP形态学指标。然后通过比较基线、测试和后测试数据，我们评估每个单独度量的一致性和变化率。急性血管扩张引起共72个ICP脉冲形态学指标的一致变化，与P1和P3亚区相比，P2亚区对脑血管变化的反应最一致，变化最大。由于脑血管的扩张/收缩导致ICP MOCIAP指标可检测到一致的变化，通过扩展的ICP监测实践，包括表征ICP脉冲形态，可以潜在地连续检测神经危重症患者的脑血管变化。
Intracranial pressure (ICP) remains a pivotal physiological signal for managing brain injury and subarachnoid hemorrhage (SAH) patients in neurocritical care units. Given the vascular origin of the ICP, changes in ICP waveform morphology could be used to infer cerebrovascular changes. Clinical validation of this association in the setting of brain trauma, and SAH is challenging due to the multi-factorial influences on, and uncertainty of, the state of the cerebral vasculature. To gain a more controlled setting, in this articel, we study ICP signals recorded in four uninjured patients undergoing a CO2 inhalation challenge in which hypercapnia induced acute cerebral vasodilatation. We apply our morphological clustering and analysis of intracranial pressure (MOCAIP) algorithm to identify six landmarks on individual ICP pulses (based on the three established ICP sub-peaks; P1, P2, and P3) and extract 128 ICP morphological metrics. Then by comparing baseline, test, and post-test data, we assess the consistency and rate of change for each individual metric. Acute vasodilatation causes consistent changes in a total of 72 ICP pulse morphological metrics and the P2 sub-region responds to cerebral vascular changes in the most consistent way with the greatest change as compared to P1 and P3 sub-regions. Since the dilation/constriction of the cerebral vasculature resulted in detectable consistent changes in ICP MOCIAP metrics, by an extended monitoring practice of ICP that includes characterizing ICP pulse morphology, one can potentially detect cerebrovascular changes, continuously, for patients under neurocritical care.
登录
查看更多内容
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：
3.4
作者：
Rao, V;Lyketsos, C
通讯作者：
Lyketsos, C
DOI：
10.1109/titb.2009.2034845
发表时间：
2010-01
期刊：
IEEE transactions on information technology in biomedicine : a publication of the IEEE Engineering in Medicine and Biology Society
影响因子：
--
作者：
Asgari S;Bergsneider M;Hu X
通讯作者：
Hu X
影响因子：
11
作者：
Czosnyka, M;Pickard, JD
通讯作者：
Pickard, JD
影响因子：
4.6
作者：
Afonso, VX;Tompkins, WJ;Luo, S
通讯作者：
Luo, S