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Red solid line: Patterns of terminal loss of cerebrovascular reactivity at the bedside.
Beqiri, Erta; Czosnyka, Marek; Placek, Michal M; Cucciolini, Giada; Motroni, Virginia; Smith, Claudia A; Hutchinson, Peter; Smielewski, Peter.
Afiliación
  • Beqiri E; Brain Physics Laboratory Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK.
  • Czosnyka M; Brain Physics Laboratory Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK.
  • Placek MM; Brain Physics Laboratory Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK.
  • Cucciolini G; Neurosurgery Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Motroni V; Brain Physics Laboratory Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK.
  • Smith CA; Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy.
  • Hutchinson P; Brain Physics Laboratory Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, UK.
  • Smielewski P; Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Italy.
Brain Spine ; 4: 102760, 2024.
Article en En | MEDLINE | ID: mdl-38510604
ABSTRACT

Introduction:

Continuous monitoring of the pressure reactivity index (PRx) provides an estimation of dynamic cerebral autoregulation (CA) at the bedside in traumatic brain injury (TBI) patients. Visualising the time-trend of PRx with a risk bar chart in ICM + software at the bedside allows for better real-time interpretability of the autoregulation status. When PRx>0.3 is sustained for long periods, typically of at least half an hour, the bar shows a pattern called "red solid line" (RSL). RSL was previously described to precede refractory intracranial hypertension and brain death. Research question We aimed to describe pathophysiological changes in measured signals/parameters during RSL. Material and

methods:

Observation of time-trends of PRx, intracranial pressure, cerebral perfusion pressure, brain oxygenation and compensatory reserve of TBI patients with RSL.

Results:

Three pathophysiological patterns were identified RSL precedes intracranial hypertension, RSL is preceded by intracranial hypertension, or RSL is preceded by brain hypoperfusion. In all cases, RSL was followed by death and the RSL onset was between 1 h and 1 day before the terminal event. Discussion and

conclusion:

RSL precedes death in intensive care and could represent a marker for terminal clinical deterioration in TBI patients. These findings warrant further investigations in larger cohorts to characterise pathophysiological mechanisms underlying the RSL pattern and whether RSL has a significant relationship with outcome after TBI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Brain Spine Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Brain Spine Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Países Bajos