Twenty-Five Years of Intracranial Pressure Monitoring After Severe Traumatic Brain Injury: A Retrospective, Single-Center Analysis
Twenty-Five Years of Intracranial Pressure Monitoring After Severe Traumatic Brain Injury: A Retrospective, Single-Center Analysis
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DOI：
10.1093/neuros/nyy468
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发表时间：
2019-07-01
期刊：
影响因子：
4.8
通讯作者：
Budohoski, Karol P.
中科院分区：
文献类型：
--
作者：
Donnelly, Joseph;Czosnyka, Marek;Budohoski, Karol P.
背景：颅内压（ICP）是严重创伤性脑损伤（TBI）后的一个重要临床变量，在英国剑桥的Addenbrooke医院已经监测了超过25年的临床结果。这一时期也见证了管理策略的变化，包括协议化专科神经危重症护理的实施、神经监测技术的扩展以及临床治疗目标的调整。目的探讨25年来颅内监测变量的变化。方法分析1146例颅脑损伤患者的颅内压监测数据。监测变量包括ICP、脑灌注压（CPP）、脑压反应性指数（PRx）。数据按5年为周期进行分层，从1992年到2017年跨越25年。结果CPP随专科神经危重症护理管理而显著增加
BACKGROUND Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period has also seen changes in management strategies with the implementation of protocolled specialist neurocritical care, expansion of neuromonitoring techniques, and adjustments of clinical treatment targets.OBJECTIVE To describe the changes in intracranial monitoring variables over the past 25 yr.METHODS Data from 1146 TBI patients requiring ICP monitoring were analyzed. Monitored variables included ICP, cerebral perfusion pressure (CPP), and the cerebral pressure reactivity index (PRx). Data were stratified into 5-yr epochs spanning the 25 yr from 1992 to 2017.RESULTS CPP increased sharply with specialist neurocritical care management (P