Object: In order to monitor cerebral autoregulation status, a software package was developed to calculate a cerebral autoregulation index (pressure reactivity index, PRx). The aim of this study is to evaluate whether the application of this methodology is feasible and useful in the clinical setting. Design: Prospective observational study. Setting: NeuroIntensive Care Unit (NICU) of a university-affiliated teaching hospital. Patients and Participants: Twenty-six consecutive patients admitted to NICU requiring intracranial pressure (ICP) and invasive arterial pressure (AP) monitoring. Measurements and Results: Patient's data were collected for a total of 902 h. Mean PRx was calculated utilizing 2 h time window. CPP-PRx distribution graphs were calculated from CPP of 20 to 110 mmHg using 10 mmHg intervals. Autoregulation was preserved in 18% observations (83/451) and deranged in 49% observations (220/451). In 33% observations (148/451), autoregulation could not be clearly defined (0 < PRx < 0.2). Even if no clinical protocol was developed, autoregulation status information inserted in clinical decision pathway influenced clinical management. Mean CPP, calculated at maximum and minimum ICP every 2 h interval, resulted different between groups with good and poor reactivity (67 ± 17.6 and 85 ± 20.0 mmHg, respectively, for autoregulating observations and 60 ± 19.1 and 67 ± 19.4 mmHg, respectively, for nonautoregulating observations, P < 0.001, independent samples t-test). PRx values were normally distributed. Conclusions: Our study demonstrates that a daily bedside measure of cerebral autoregulation is feasible. PRx values can support clinicians in the identification of a targeted CPP in patients suffering from different intracranial pathologies and requiring an intensive monitoring. © 2008 Humana Press Inc.

Consonni, F., Abate, M., Galli, D., & Citerio, G. (2009). Feasibility of a continuous computerized monitoring of cerebral autoregulation in neurointensive care. NEUROCRITICAL CARE, 10(2), 232-240 [10.1007/s12028-008-9151-2].

Feasibility of a continuous computerized monitoring of cerebral autoregulation in neurointensive care

CONSONNI, FRANCESCO
;
ABATE, MARIA GIULIA
;
CITERIO, GIUSEPPE
2009

Abstract

Object: In order to monitor cerebral autoregulation status, a software package was developed to calculate a cerebral autoregulation index (pressure reactivity index, PRx). The aim of this study is to evaluate whether the application of this methodology is feasible and useful in the clinical setting. Design: Prospective observational study. Setting: NeuroIntensive Care Unit (NICU) of a university-affiliated teaching hospital. Patients and Participants: Twenty-six consecutive patients admitted to NICU requiring intracranial pressure (ICP) and invasive arterial pressure (AP) monitoring. Measurements and Results: Patient's data were collected for a total of 902 h. Mean PRx was calculated utilizing 2 h time window. CPP-PRx distribution graphs were calculated from CPP of 20 to 110 mmHg using 10 mmHg intervals. Autoregulation was preserved in 18% observations (83/451) and deranged in 49% observations (220/451). In 33% observations (148/451), autoregulation could not be clearly defined (0 < PRx < 0.2). Even if no clinical protocol was developed, autoregulation status information inserted in clinical decision pathway influenced clinical management. Mean CPP, calculated at maximum and minimum ICP every 2 h interval, resulted different between groups with good and poor reactivity (67 ± 17.6 and 85 ± 20.0 mmHg, respectively, for autoregulating observations and 60 ± 19.1 and 67 ± 19.4 mmHg, respectively, for nonautoregulating observations, P < 0.001, independent samples t-test). PRx values were normally distributed. Conclusions: Our study demonstrates that a daily bedside measure of cerebral autoregulation is feasible. PRx values can support clinicians in the identification of a targeted CPP in patients suffering from different intracranial pathologies and requiring an intensive monitoring. © 2008 Humana Press Inc.
Articolo in rivista - Articolo scientifico
Autoregulation; Intracranial hypertension; Intracranial pressure; Adult; Diagnosis, Computer-Assisted; Feasibility Studies; Female; Homeostasis; Humans; Intensive Care; Intracranial Hypertension; Intracranial Pressure; Male; Middle Aged; Monitoring, Physiologic; Prospective Studies; Software; Critical Care and Intensive Care Medicine; Neurology (clinical)
English
232
240
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Consonni, F., Abate, M., Galli, D., & Citerio, G. (2009). Feasibility of a continuous computerized monitoring of cerebral autoregulation in neurointensive care. NEUROCRITICAL CARE, 10(2), 232-240 [10.1007/s12028-008-9151-2].
Consonni, F; Abate, M; Galli, D; Citerio, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/55210
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