J Clin Monit Comput - An optimal frequency range for assessing the pressure reactivity index in patients with traumatic brain injury.

Tópicos

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Resumo

The objective of this study was to identify the optimal frequency range for computing the pressure reactivity index (PRx). PRx is a clinical method for assessing cerebral pressure autoregulation based on the correlation of spontaneous variations of arterial blood pressure (ABP) and intracranial pressure (ICP). Our hypothesis was that optimizing the methodology for computing PRx in this way could produce a more stable, reliable and clinically useful index of autoregulation status. The patients studied were a series of 131 traumatic brain injury patients. Pressure reactivity indices were computed in various frequency bands during the first 4 days following injury using bandpass filtering of the input ABP and ICP signals. Patient outcome was assessed using the extended Glasgow Outcome Scale (GOSe). The optimization criterion was the strength of the correlation with GOSe of the mean index value over the first 4 days following injury. Stability of the indices was measured as the mean absolute deviation of the minute by minute index value from 30-min moving averages. The optimal index frequency range for prediction of outcome was identified as 0.018-0.067 Hz (oscillations with periods from 55 to 15 s). The index based on this frequency range correlated with GOSe with =-0.46 compared to -0.41 for standard PRx, and reduced the 30-min variation by 23%.

Resumo Limpo

object studi identifi optim frequenc rang comput pressur reactiv index prx prx clinic method assess cerebr pressur autoregul base correl spontan variat arteri blood pressur abp intracrani pressur icp hypothesi optim methodolog comput prx way produc stabl reliabl clinic use index autoregul status patient studi seri traumat brain injuri patient pressur reactiv indic comput various frequenc band first day follow injuri use bandpass filter input abp icp signal patient outcom assess use extend glasgow outcom scale gose optim criterion strength correl gose mean index valu first day follow injuri stabil indic measur mean absolut deviat minut minut index valu min move averag optim index frequenc rang predict outcom identifi hz oscil period s index base frequenc rang correl gose compar standard prx reduc min variat

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