An evaluation of three measures of intracranial compliance in traumatic brain injury patients
An evaluation of three measures of intracranial compliance in traumatic brain injury patients
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DOI：
10.1007/s00134-012-2571-7
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发表时间：
2012-06-01
影响因子：
38.9
通讯作者：
Enblad, Per
中科院分区：
文献类型：
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作者：
Howells, Tim;Lewen, Anders;Enblad, Per
比较颅内压 (ICP) 幅度、ICP 斜率以及 ICP 幅度和 ICP 平均值（RAP 指数）的相关性，作为一组创伤性脑损伤 (TBI) 患者的依从性测量。这三个测量值的平均值是在手术前和手术后（开颅手术和撤离）2 小时内以及硫喷妥钠前后 12 小时内计算的。 治疗期间以及硫喷妥钠昏迷期间。使用 Wilcoxon 检验评估指标的变化。评估了三个指标的 10 天平均值与年龄、入院格拉斯哥运动评分 (GMS) 和扩展格拉斯哥结果评分 (GOSe) 的相关性。还使用学生测试对 60 岁以下和 60 岁以上的患者进行了比较。分析ICP波幅与全身脉搏波幅的相关性。ICP波幅与GMS显着相关，对于35岁及以上的患者也与年龄显着相关。 ICP斜率和RAP指数与GMS和年龄的相关性不显着。所有三个指标都表明手术后和硫喷妥钠昏迷期间的依从性显着改善。没有一个指标与结果显着相关，可能是由于治疗因素的混杂影响。全身脉冲幅度与 ICP 幅度的相关性较低 (= 0.18)，仅解释 3% 的方差。本研究进一步验证了 ICP 波形的所有这三个特征作为依从性的衡量标准。 ICP振幅在这些测试中具有最好的性能。
To compare intracranial pressure (ICP) amplitude, ICP slope, and the correlation of ICP amplitude and ICP mean (RAP index) as measures of compliance in a cohort of traumatic brain injury (TBI) patients.Mean values of the three measures were calculated in the 2-h periods before and after surgery (craniectomies and evacuations), and in the 12-h periods preceding and following thiopental treatment, and during periods of thiopental coma. The changes in the metrics were evaluated using the Wilcoxon test. The correlations of 10-day mean values for the three metrics with age, admission Glasgow Motor Score (GMS), and Extended Glasgow Outcome Score (GOSe) were evaluated. Patients under and over 60 years old were also compared using the Student test. The correlation of ICP amplitude with systemic pulse amplitude was analyzed.ICP amplitude was significantly correlated with GMS, and also with age for patients 35 years old and older. The correlations of ICP slope and the RAP index with GMS and with age were not significant. All three metrics indicated significant improvements in compliance following surgery and during thiopental coma. None of the metrics were significantly correlated with outcome, possibly due to confounding effects of treatment factors. The correlation of systemic pulse amplitude with ICP amplitude was low ( = 0.18), only explaining 3 % of the variance.This study provides further validation for all three of these features of the ICP waveform as measures of compliance. ICP amplitude had the best performance in these tests.